Provider Demographics
NPI:1528186681
Name:VANDENHUL, MICHELLE (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:VANDENHUL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2707
Mailing Address - Country:US
Mailing Address - Phone:605-271-1348
Mailing Address - Fax:605-610-1477
Practice Address - Street 1:5000 S MINNESOTA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2707
Practice Address - Country:US
Practice Address - Phone:605-271-1348
Practice Address - Fax:605-610-1477
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2227101YM0800X
SD27401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health