Provider Demographics
NPI:1518981190
Name:BERKLAND, TERRE MARIE (MSW/PIP)
Entity Type:Individual
Prefix:
First Name:TERRE
Middle Name:MARIE
Last Name:BERKLAND
Suffix:
Gender:F
Credentials:MSW/PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PARK ST
Mailing Address - Street 2:SUITE 13
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-3846
Mailing Address - Country:US
Mailing Address - Phone:605-661-5176
Mailing Address - Fax:605-665-2036
Practice Address - Street 1:500 PARK ST
Practice Address - Street 2:SUITE 13
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-3846
Practice Address - Country:US
Practice Address - Phone:605-661-5176
Practice Address - Fax:605-665-2036
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6571033Medicaid
SD4995077OtherWELLMARK