| Bosworth Therapy & Consultation Services Inc | |
|
2650 Jackson Blvd Rapid City SD 57702 | |
| (605) 343-7755 | |
| (605) 721-8896 |
| Full Name | Bosworth Therapy & Consultation Services Inc |
|---|---|
| Speciality | Social Worker |
| Location | 2650 Jackson Blvd, Rapid City, South Dakota |
| Authorized Official Name and Position | Thomas Matthew Bosworth (PRESIDENT) |
| Authorized Official Contact | 6053437755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bosworth Therapy & Consultation Services Inc 3213 West Main Street # 215 Rapid City SD 57702 Ph: (605) 343-7755 | Bosworth Therapy & Consultation Services Inc 2650 Jackson Blvd Rapid City SD 57702 Ph: (605) 343-7755 |
| NPI Number | 1548203730 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 04/23/2015 |
| Medicare PECOS PAC ID | 0143650622 |
|---|---|
| Medicare Enrollment ID | O20200423003577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548203730 | NPI | - | NPPES |
| 6570593 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1590 (South Dakota) | Primary |
| Provider Name | Thomas Bosworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306906011 PECOS PAC ID: 1052741535 Enrollment ID: I20200506002373 |
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