Provider Demographics
NPI:1023075645
Name:SALAZAR, JODI ESTHER (CSW-PIP MSW)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:ESTHER
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:CSW-PIP MSW
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:910 W HAVENS STREET
Mailing Address - Street 2:DAKOTA COUNSELING INSTITUTE
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301
Mailing Address - Country:US
Mailing Address - Phone:605-996-9686
Mailing Address - Fax:605-996-1624
Practice Address - Street 1:910 W HAVENS STREET
Practice Address - Street 2:DAKOTA COUNSELING INSTITUTE
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301
Practice Address - Country:US
Practice Address - Phone:605-996-9686
Practice Address - Fax:605-996-1624
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCSWPIP 21181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0041708OtherWELLMARK BC/BS
SD21087OtherSIOUX VALLEY HEALTH
SD9221852OtherDAKOTACARE
SD9221852OtherDAKOTACARE