Provider Demographics
NPI:1497499099
Name:EBEN COUNSELING
Entity Type:Organization
Organization Name:EBEN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINIC SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:EBEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-PIP
Authorized Official - Phone:605-351-8692
Mailing Address - Street 1:905 S THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-2838
Mailing Address - Country:US
Mailing Address - Phone:605-351-8692
Mailing Address - Fax:
Practice Address - Street 1:300 N DAKOTA AVE STE 205
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6023
Practice Address - Country:US
Practice Address - Phone:605-351-8692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty