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Organization

BLACK HILLS PSYCHOLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHANNON JEAN MAXWELL PSY.D (OWNER, AUTHORIZED OFFICIAL)
(513) 304-4750
Entity
Organization

Contact information

Practice address
115 N 7TH ST STE 6, SPEARFISH, SD 57783-2710
(605) 645-0100
(605) 717-1009
Mailing address
115 N 7TH ST STE 6, SPEARFISH, SD 57783-2710
(605) 645-0100
(605) 717-1009

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SD
101YP2500X
Professional Counselor
000000
SD
103TC0700X
Clinical Psychologist
Primary
0000
SD
103TC1900X
Counseling Psychologist
SD
103TC2200X
Clinical Child & Adolescent Psychologist
0000
SD
1041C0700X
Clinical Social Worker
0000
SD
2084P0800X
Psychiatry Physician
2084P0804X
Child & Adolescent Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2001655
SD
Enumeration date
12/13/2010
Last updated
01/20/2026
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