# BLACK HILLS CENTER FOR HEALING AND ADVANCEMENT OF PSYCHOTHERAPY PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710442017
- **Authorized official:** ELIZABETH OSTOLOZAGA LCSW-PIP (OWNER)
- **Authorized official phone:** (605) 440-2287

## Contact information

- **Practice address:** 2525 W MAIN ST STE 303A6, RAPID CITY, SD 57702-2437
- **Practice address phone:** (605) 440-2287
- **Practice address fax:** (605) 791-2086
- **Mailing address:** 2525 W MAIN ST STE 303A6, RAPID CITY, SD 57702-2437
- **Mailing address phone:** (605) 440-2287
- **Mailing address fax:** (605) 791-2086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2019
- **Last updated:** 01/31/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2013208 | — | SD |