Provider Demographics
NPI:1508474727
Name:PRAIRIE SKIES PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:PRAIRIE SKIES PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-661-0095
Mailing Address - Street 1:905 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-3415
Mailing Address - Country:US
Mailing Address - Phone:605-661-0095
Mailing Address - Fax:
Practice Address - Street 1:327 BROADWAY AVE STE 13
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-7800
Practice Address - Country:US
Practice Address - Phone:605-661-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty