Provider Demographics
NPI:1538641501
Name:SUSAN DINSMORE TERRY LLC
Entity Type:Organization
Organization Name:SUSAN DINSMORE TERRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DINSMORE TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:605-777-2235
Mailing Address - Street 1:5000 S MINNESOTA AVE STE 3000
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2707
Mailing Address - Country:US
Mailing Address - Phone:605-777-2235
Mailing Address - Fax:
Practice Address - Street 1:5000 S MINNESOTA AVE STE 3000
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2707
Practice Address - Country:US
Practice Address - Phone:605-777-2235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT20206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty