| Black Hills Psychology, Llc | |
|
115 N 7th St Ste 6 Spearfish SD 57783-2710 | |
| (605) 645-0100 | |
| (605) 717-1009 |
| Full Name | Black Hills Psychology, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 115 N 7th St Ste 6, Spearfish, South Dakota |
| Authorized Official Name and Position | Shannon Jean Maxwell (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5133044750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Psychology, Llc 115 N 7th St Ste 6 Spearfish SD 57783-2710 Ph: (605) 645-0100 | Black Hills Psychology, Llc 115 N 7th St Ste 6 Spearfish SD 57783-2710 Ph: (605) 645-0100 |
| NPI Number | 1811290992 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 4587852009 |
|---|---|
| Medicare Enrollment ID | O20101228000962 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811290992 | NPI | - | NPPES |
| 2001655 | Medicaid | SD |
| Provider Name | Shannon Jean Maxwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790058089 PECOS PAC ID: 4486970407 Enrollment ID: I20150310000026 |
| Provider Name | Cherise Deann Lerew |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184910911 PECOS PAC ID: 5092034512 Enrollment ID: I20150505002796 |
| Provider Name | Emilia Sue Flint |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023485646 PECOS PAC ID: 4789994591 Enrollment ID: I20151106001782 |
| Provider Name | Adam J Opbroek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629024120 PECOS PAC ID: 4385616960 Enrollment ID: I20160301002329 |
| Provider Name | Mark J Britzman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457700361 PECOS PAC ID: 2668764978 Enrollment ID: I20160707000327 |
| Provider Name | Rita L Vannorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952433302 PECOS PAC ID: 5890889505 Enrollment ID: I20181002003624 |
| Provider Name | Katherine L Corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487293692 PECOS PAC ID: 2860814209 Enrollment ID: I20200612000881 |
| Provider Name | Erica L Fett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093316168 PECOS PAC ID: 8123439494 Enrollment ID: I20201118001873 |
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