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Organization
DAKOTA SOUTHWESTERN WELLNESS, P. L.L.C.
Active
Organization
DAKOTA SOUTHWESTERN WELLNESS, P. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA KATHRYN WALLER LICSW, DCSW, LAC (AUTHORIZED OFFICIAL)
(701) 279-6981
Entity
Organization
Contact information
Practice address
606 4TH ST SW, BOWMAN, ND 58623-4527
(701) 523-6985
(701) 279-7185
Mailing address
PO BOX 475, BOWMAN, ND 58623-0475
(701) 279-6981
(701) 279-7185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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