| Bridgewater Behavioral Health, Llc | |
|
902 Columbus St Rapid City SD 57701-3543 | |
| (605) 791-1514 | |
| (844) 831-2349 |
| Full Name | Bridgewater Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 902 Columbus St, Rapid City, South Dakota |
| Authorized Official Name and Position | Genni L Goschke (PRESIDENT) |
| Authorized Official Contact | 6057911514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgewater Behavioral Health, Llc Po Box 1990 Rapid City SD 57709-1990 Ph: (605) 791-1514 | Bridgewater Behavioral Health, Llc 902 Columbus St Rapid City SD 57701-3543 Ph: (605) 791-1514 |
| NPI Number | 1588048201 |
|---|---|
| Provider Enumeration Date | 07/13/2015 |
| Last Update Date | 07/13/2015 |
| Medicare PECOS PAC ID | 7911216502 |
|---|---|
| Medicare Enrollment ID | O20151021003194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588048201 | NPI | - | NPPES |
| 1679550065 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 479 (South Dakota) | Primary |
| Provider Name | Genni L Goschke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679550065 PECOS PAC ID: 8729019278 Enrollment ID: I20090915000436 |
| Provider Name | Eric D Traub |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356786917 PECOS PAC ID: 7719126523 Enrollment ID: I20130626000466 |
| Provider Name | Chantal M Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427469519 PECOS PAC ID: 4981820024 Enrollment ID: I20140724002338 |
Childrens Home Society Of South Dakota Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1330 Jolly Ln, Rapid City, SD 57703 Phone: 605-343-2811 Fax: 605-341-7437 | |
Isaacs Behavioral Health, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2650 Jackson Blvd, Rapid City, SD 57702 Phone: 605-877-2010 | |
Youth & Family Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Adams St, Rapid City, SD 57701 Phone: 605-342-4789 | |
Mark W. Perrenoud Ph.d. Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1818 West Fulton, Suite 201, Rapid City, SD 57702 Phone: 605-348-6500 Fax: 605-341-7409 | |
Debra Hughes Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Centre St, Suite 101, Rapid City, SD 57703 Phone: 605-347-1369 | |
Melissa Good, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4310 W Main St Apt 20c, Rapid City, SD 57702 Phone: 605-431-3292 | |
Cornell Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 900 Concourse Dr Ste E-227, Rapid City, SD 57703 Phone: 605-549-5433 Fax: 605-309-7919 |