Provider Demographics
NPI:1740749803
Name:PANSCH, NORMA K (MA, LPC-MH, QMHP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:K
Last Name:PANSCH
Suffix:
Gender:F
Credentials:MA, LPC-MH, QMHP
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:K
Other - Last Name:RUNNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC-MH, QMHP
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-0250
Mailing Address - Country:US
Mailing Address - Phone:605-209-0446
Mailing Address - Fax:
Practice Address - Street 1:2040 W MAIN ST STE 305
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2447
Practice Address - Country:US
Practice Address - Phone:605-209-0446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH30625101YM0800X
SDLPC200555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional