Provider Demographics
NPI:1578744504
Name:SCOVEL PSYCHOLOGICAL AND COUNSELING SERVICES, LTD
Entity Type:Organization
Organization Name:SCOVEL PSYCHOLOGICAL AND COUNSELING SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOVEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:605-721-8822
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-0387
Mailing Address - Country:US
Mailing Address - Phone:605-721-8822
Mailing Address - Fax:605-721-8928
Practice Address - Street 1:636 SAINT ANNE ST STE 103
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4694
Practice Address - Country:US
Practice Address - Phone:605-721-8822
Practice Address - Fax:605-721-8928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD439103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6552060Medicaid
SD6552060Medicaid