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Contact Information

BRIDGEWATER BEHAVIORAL HEALTH, LLC
902 COLUMBUS ST
RAPID CITY, SD57701-3543
 Phone: 605-791-1514
 Fax: 844-831-2349
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRIDGEWATER BEHAVIORAL HEALTH LLC · (Female)

NPI # 1588048201
Status Active
Credentials
Entity Individual
Enumeration date 07/13/2015
Last updated 07/13/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • SD License # 479
  • SD Medicaid 1679550065
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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