Provider Demographics
NPI:1487796439
Name:HOWARD, GREGORY (MSW, PHD, CSW-PIP)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MSW, PHD, CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 SAINT ANNE ST
Mailing Address - Street 2:STE #101
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4694
Mailing Address - Country:US
Mailing Address - Phone:605-716-7300
Mailing Address - Fax:605-716-1300
Practice Address - Street 1:636 SAINT ANNE ST
Practice Address - Street 2:STE #101
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4694
Practice Address - Country:US
Practice Address - Phone:605-716-7300
Practice Address - Fax:605-716-1300
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD13811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4995651OtherWELLMARK BCBS PROVIDER #
SD6570303Medicaid
SDS41970Medicare PIN