# BLUEGREEN COUNSELING & WELLNESS, LLC

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

## Provider details

- **NPI number:** 1861206583
- **Authorized official:** MARY ANN FREDRICKSON CSW-PIP (CLINICAL SOCIAL WORKER/OWNER)
- **Authorized official phone:** (210) 846-9037

## Contact information

- **Practice address:** 1601 MOUNT RUSHMORE RD STE 3-202, RAPID CITY, SD 57701-4591
- **Practice address phone:** (210) 846-9037
- **Mailing address:** 1601 MOUNT RUSHMORE RD STE 3-202, RAPID CITY, SD 57701-4591
- **Mailing address phone:** (210) 846-9037

## Taxonomy

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

## Other

- **Enumeration date:** 02/04/2025
- **Last updated:** 02/04/2025