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Organization

HUMAN SERVICE AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KARI JOHNSTON LPC-MH (CEO)
(605) 886-0123
Entity
Organization

Contact information

Practice address
123 19TH ST NE, WATERTOWN, SD 57201-2823
(605) 886-0123
(605) 886-5447
Mailing address
123 19TH ST NE, WATERTOWN, SD 57201-2823
(605) 886-0123
(605) 886-5447

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
006
SD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
704
SD
103T00000X
Psychologist
006
SD
103TA0400X
Addiction (Substance Use Disorder) Psychologist
704
SD
2084P0800X
Psychiatry Physician
006
SD
2084P0802X
Addiction Psychiatry Physician
704
SD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
006
SD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
704
SD
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
006
SD
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
704
SD
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
006
SD
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
704
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0180020
SD
05
5001040
SD
05
5200010
SD
05
5255010
SD
05
5256010
SD
05
5261010
SD
Enumeration date
09/26/2005
Last updated
08/06/2024
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