{"npi":"1588048201","type":"NPI-2","status":"active","name":{"display":"Bridgewater Behavioral Health, LLC","other":[],"organization_name":"BRIDGEWATER BEHAVIORAL HEALTH, LLC","authorised_official":"Genni Goschke"},"specialty":{"primary_taxonomy":"103T00000X","primary_taxonomy_description":"Psychologist","slug":"psychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":true,"state":"SD","license":"479"}]},"addresses":[{"purpose":"LOCATION","street_1":"902 COLUMBUS ST","city":"RAPID CITY","state":"SD","postal_code":"577013543","country_code":"US","phone":"6057911514","fax":"8448312349"},{"purpose":"MAILING","street_1":"PO BOX 1990","city":"RAPID CITY","state":"SD","postal_code":"577091990","country_code":"US","phone":"6057911514","fax":"8448312349"}],"license":{"state":"SD","number":"479"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1679550065","state":"SD","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20151021003194","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"SD","pac_id":"7911216502"}]},"enumeration_date":"2015-07-13","last_updated":"2015-07-13","_meta":{"source":"NPPES","snapshot_date":"2015-07-13","doc_url":"https://findmynpi.com/api"}}