CAROL BUTZMAN LPCMH CCDCIII QMHP
Addiction Substance Use Disorder
Rapid City, South Dakota
Provider NPI: 1922076553
Provider Information:CAROL BUTZMAN LPCMH CCDCIII QMHP
Gender: F
Not Sole Proprietor
Practice Location:
4940 5TH STREET SUITE 1B RAPID CITY, SD 57701 US
Tel: 605-418-4004 Fax: 605-418-4002
Business Mailing Address:
4940 5TH STREET SUITE 1B RAPID CITY, SD 57701 US
Tel: 605-418-4004 Fax: 605-418-4002
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | SD | ICADC14768 |
N | 101YA0400X | Behavioral Health & Social Service Providers Counselor | SD | CCDCIII |
Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor | SD | LPCMH2009 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AVERA | 23145 | SD | 01 |
SIOUX VALLEY | 23145 | SD | 01 |
BCBS | 4998865 | SD | 01 |
DAKOTACARE | NP4273 | SD | 01 |
6575060 | SD | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin