Provider Demographics
NPI:1033819636
Name:MCLAUGHLLIN, TOMMIE RAE (BSCJ/HS)
Entity Type:Individual
Prefix:
First Name:TOMMIE
Middle Name:RAE
Last Name:MCLAUGHLLIN
Suffix:
Gender:F
Credentials:BSCJ/HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6872 POLK ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSET
Mailing Address - State:SD
Mailing Address - Zip Code:57718-9228
Mailing Address - Country:US
Mailing Address - Phone:605-454-1778
Mailing Address - Fax:
Practice Address - Street 1:308 QUINCY ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5770
Practice Address - Country:US
Practice Address - Phone:605-343-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician