Provider Demographics
NPI:1891320867
Name:JOCKHECK COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:JOCKHECK COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS, LPC-MH, CDVC III, QMHP
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOCKHECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-224-7247
Mailing Address - Street 1:740 E SIOUX AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-3396
Mailing Address - Country:US
Mailing Address - Phone:605-224-7247
Mailing Address - Fax:605-224-5660
Practice Address - Street 1:740 E SIOUX AVE STE 110
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3396
Practice Address - Country:US
Practice Address - Phone:605-224-7247
Practice Address - Fax:605-224-5660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)