Organization
NORTHERN HILLS PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON JEAN MAXWELL PSY.D (OWNER)
(605) 641-8880
Entity
Organization
Contact information
Practice address
1130 N MAIN ST STE 1, SPEARFISH, SD 57783-3017
(605) 641-8880
Mailing address
1130 N MAIN ST STE 1, SPEARFISH, SD 57783-3017
(605) 641-8880
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
530
SD
103TC2200X
Clinical Child & Adolescent Psychologist
530
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881181642
—
SD
Enumeration date
04/17/2018
Last updated
03/12/2019
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