| Enso Mental Health, Llc | |
|
211 N Main St Ste 104 Spearfish SD 57783-2646 | |
| (605) 519-5850 | |
| Not Available |
| Full Name | Enso Mental Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 N Main St Ste 104, Spearfish, South Dakota |
| Authorized Official Name and Position | Joanna Marye Prewitt (OWNER/PRESIDENT) |
| Authorized Official Contact | 6055195850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enso Mental Health, Llc Po Box 922 Spearfish SD 57783-0922 Ph: (695) 519-5850 | Enso Mental Health, Llc 211 N Main St Ste 104 Spearfish SD 57783-2646 Ph: (605) 519-5850 |
| NPI Number | 1912541921 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 11/01/2019 |
| Medicare PECOS PAC ID | 0749651883 |
|---|---|
| Medicare Enrollment ID | O20230127000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912541921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Katy A Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487266722 PECOS PAC ID: 8820409170 Enrollment ID: I20201118001089 |
| Provider Name | Shannon Heather Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205108396 PECOS PAC ID: 5496199341 Enrollment ID: I20240219002249 |
| Provider Name | Joanna M Prewitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750802450 PECOS PAC ID: 5294106332 Enrollment ID: I20240222002119 |
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