Provider Demographics
NPI:1235212754
Name:HINSETH, MICHELLE MERRIGAN (CSWPIP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MERRIGAN
Last Name:HINSETH
Suffix:
Gender:F
Credentials:CSWPIP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:NICOLE
Other - Last Name:MERRIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSWPIP
Mailing Address - Street 1:427 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-3468
Mailing Address - Country:US
Mailing Address - Phone:605-670-2885
Mailing Address - Fax:
Practice Address - Street 1:20 S PLUM ST
Practice Address - Street 2:
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-3346
Practice Address - Country:US
Practice Address - Phone:605-638-8317
Practice Address - Fax:605-624-4001
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD21141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6571350Medicaid
SD6571350Medicaid
SDS102318Medicare PIN