Individual
MR. DAVID JETSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC - MH
Contact information
Practice address
636 SAINT ANNE ST, SUITE 202, RAPID CITY, SD 57701-4694
(605) 718-5500
(605) 716-9944
Mailing address
1301 WEST OMAHA ST., SUITE 220, RAPID CITY, SD 57701-4694
(605) 718-5500
(605) 716-0415
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-MH2145
SD
101YM0800X
Mental Health Counselor
Primary
LPC-MH2145
SD
101YP2500X
Professional Counselor
LPC-MH2145
SD
Other
Enumeration date
06/09/2006
Last updated
06/03/2021
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