| Psychological Evaluation Therapy & Research Ltd | |
|
3601 Canyon Lake Drive Rapid City SD 57702 | |
| (605) 341-8647 | |
| (605) 341-0489 |
| Full Name | Psychological Evaluation Therapy & Research Ltd |
|---|---|
| Speciality | Psychologist |
| Location | 3601 Canyon Lake Drive, Rapid City, South Dakota |
| Authorized Official Name and Position | Dewey J Ertz (PRESIDENT PSYCHOLOGIST) |
| Authorized Official Contact | 6053418647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Evaluation Therapy & Research Ltd 3601 Canyon Lake Drive Rapid City SD 57702 Ph: (605) 341-8647 | Psychological Evaluation Therapy & Research Ltd 3601 Canyon Lake Drive Rapid City SD 57702 Ph: (605) 341-8647 |
| NPI Number | 1790709145 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9931286838 |
|---|---|
| Medicare Enrollment ID | O20080402000576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790709145 | NPI | - | NPPES |
| Provider Name | Dewey J Ertz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164606570 PECOS PAC ID: 6305922790 Enrollment ID: I20080326000136 |
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