Provider Demographics
NPI:1649051483
Name:THE GIVING GOAT LLC
Entity type:Organization
Organization Name:THE GIVING GOAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL LICENSED SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LOREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:605-939-0296
Mailing Address - Street 1:1420 NORTH AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1543
Mailing Address - Country:US
Mailing Address - Phone:605-939-0296
Mailing Address - Fax:
Practice Address - Street 1:1410 NORTH AVE STE 3
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1574
Practice Address - Country:US
Practice Address - Phone:605-939-0296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1114153772OtherNPPES