Provider Demographics
NPI:1588239818
Name:SIOUX FALLS MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SIOUX FALLS MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDEM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, PLC-MH,QMHP
Authorized Official - Phone:605-212-4357
Mailing Address - Street 1:100 N KROHN PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-1815
Mailing Address - Country:US
Mailing Address - Phone:605-212-4357
Mailing Address - Fax:
Practice Address - Street 1:100 N KROHN PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-1815
Practice Address - Country:US
Practice Address - Phone:605-212-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty