Provider Demographics
NPI:1093260523
Name:PERSON, JACALYN (CSW-PIP)
Entity Type:Individual
Prefix:
First Name:JACALYN
Middle Name:
Last Name:PERSON
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:JACALYN
Other - Middle Name:
Other - Last Name:HOPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-9419
Mailing Address - Fax:
Practice Address - Street 1:922 22ND AVE S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2830
Practice Address - Country:US
Practice Address - Phone:605-697-1900
Practice Address - Fax:605-697-1919
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD49451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical