Ertz, Dewey J.
Ertz, Dewey J. is an individual health care provider with primary practice located at 3601 Canyon Lake Dr , Rapid City SD 57702-3900. He recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Rehabilitation, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Ertz, Dewey J. can be contacted via phone (605) 341-8647.Contact Information
Primary practice address
3601 Canyon Lake Dr
Rapid City SD 57702-3900
Phone: (605) 341-8647
Fax: (605) 341-0489
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | 123 | South Dakota |
| Behavioral Health & Social Service Providers / School | 103TS0200X | 29664-02 | South Dakota |
Profile Details
| NPI number | 1164606570 |
|---|---|
| LBN Legal business name | Ertz, Dewey J. |
| Credentials | ED.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2007 |
| Last updated | Dec 20th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164606570 | NPPES |
| South Dakota | MEDICAID | 6550193 | |
| South Dakota | MEDICAID | 460461452-26 |
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