Provider Demographics
NPI:1467118513
Name:REVERENCE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:REVERENCE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH, LAC
Authorized Official - Phone:605-937-6654
Mailing Address - Street 1:5021 S BUR OAK PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2228
Mailing Address - Country:US
Mailing Address - Phone:605-937-6654
Mailing Address - Fax:605-937-6749
Practice Address - Street 1:5021 S BUR OAK PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2228
Practice Address - Country:US
Practice Address - Phone:605-937-6654
Practice Address - Fax:605-937-6749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty