Provider Demographics
NPI:1467190629
Name:VAN VOORST, JAMIE R (LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:R
Last Name:VAN VOORST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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:
Mailing Address - Fax:
Practice Address - Street 1:111 CLIFF AVE N
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032
Practice Address - Country:US
Practice Address - Phone:605-328-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20693101YP2500X
SD30779101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional