Provider Demographics
NPI:1619990009
Name:NIEDERT-HOHM, ELLEN JANET (MS, LPC-MS, QMHP)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:JANET
Last Name:NIEDERT-HOHM
Suffix:
Gender:F
Credentials:MS, LPC-MS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 S TENNIS LN
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2256
Mailing Address - Country:US
Mailing Address - Phone:661-440-3063
Mailing Address - Fax:605-362-5601
Practice Address - Street 1:4410 S TENNIS LN
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2256
Practice Address - Country:US
Practice Address - Phone:661-440-3063
Practice Address - Fax:605-362-5601
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2119101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health