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PSYCHOLOGICAL EVALUATION THERAPY & RESEARCH LTD NPI 1790709145


NPI Information

NPI: 1790709145
Provider Name: PSYCHOLOGICAL EVALUATION THERAPY & RESEARCH LTD
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
3601 CANYON LAKE DRIVE
RAPID CITY, SD
ZIP 57702
Phone: (605) 341-8647
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PSYCHOLOGICAL EVALUATION THERAPY & RESEARCH LTD is an addiction (substance use disorder) psychologist in Rapid City, SD. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. PSYCHOLOGICAL EVALUATION THERAPY & RESEARCH LTD NPI is 1790709145. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3601 CANYON LAKE DRIVE
RAPID CITY, SD
ZIP 57702
Phone: (605) 341-8647
Fax: (605) 341-0489

The provider's authorized official is Dewey J Ertz .
The authorized official title is President Psychologist and has the following contact phone number (605) 341-8647.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)123SOUTH DAKOTAYes
2103TC0700XPsychologistClinical123SOUTH DAKOTAX
3103TF0000XPsychologistFamily123SOUTH DAKOTAX
4103TF0200XPsychologistForensic123SOUTH DAKOTAX
5103TM1800XPsychologistIntellectual and Developmental Disabilities123SOUTH DAKOTAX
6103T00000XPsychologist123SOUTH DAKOTAX
7103TR0400XPsychologistRehabilitation123SOUTH DAKOTAX
8103TS0200XPsychologistSchool123SOUTH DAKOTAX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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