Provider Demographics
NPI:1073593844
Name:GUEST, KAREN SUE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SUE
Last Name:GUEST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E CLEMMER AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-1308
Mailing Address - Country:US
Mailing Address - Phone:605-734-6347
Mailing Address - Fax:605-734-0577
Practice Address - Street 1:108 E CLEMMER AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-1308
Practice Address - Country:US
Practice Address - Phone:605-734-6347
Practice Address - Fax:605-734-0577
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT1161106H00000X
SD350103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0003766OtherWELLMARK BLUE CROSS BLUE
SD6550760Medicaid
SD21903OtherSIOUX VALLEY HEALTH
SD0003766OtherWELLMARK BLUE CROSS BLUE