Provider Demographics
NPI:1033705777
Name:NICOLE VELGERSDYK COUNSELING, LLC
Entity Type:Organization
Organization Name:NICOLE VELGERSDYK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELGERSDYK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:712-249-4590
Mailing Address - Street 1:3240 E BISON TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8006
Mailing Address - Country:US
Mailing Address - Phone:605-961-4746
Mailing Address - Fax:605-961-4747
Practice Address - Street 1:3240 E BISON TRL STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8006
Practice Address - Country:US
Practice Address - Phone:605-961-4746
Practice Address - Fax:605-961-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)