Basic Information
| Provider Information | |||||||||
| NPI: | 1972231751 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VOGT | ||||||||
| FirstName: | TORI | ||||||||
| MiddleName: | SARAH | ||||||||
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| Credential: | LMSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 DOROTHY AVE | ||||||||
| Address2: | |||||||||
| City: | BONESTEEL | ||||||||
| State: | SD | ||||||||
| PostalCode: | 573172020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6056542476 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 DIAMOND ST | ||||||||
| Address2: | |||||||||
| City: | ONAWA | ||||||||
| State: | IA | ||||||||
| PostalCode: | 510401548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7124232311 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2022 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 5190 | SD | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | 100180 | IA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.