Provider Demographics
NPI:1134300973
Name:GREGORY HOWARD, PH.D., CSW-PIP, INC.
Entity Type:Organization
Organization Name:GREGORY HOWARD, PH.D., CSW-PIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW PHD CSW-PIP
Authorized Official - Phone:605-716-1300
Mailing Address - Street 1:636 SAINT ANNE ST
Mailing Address - Street 2:SUITE #101
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4694
Mailing Address - Country:US
Mailing Address - Phone:605-716-1300
Mailing Address - Fax:605-716-1300
Practice Address - Street 1:636 SAINT ANNE ST
Practice Address - Street 2:SUITE #101
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4694
Practice Address - Country:US
Practice Address - Phone:605-716-1300
Practice Address - Fax:605-716-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD13811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6570303Medicaid
SDS41968Medicare PIN