Provider Demographics
NPI:1659642668
Name:FEIOCK, CHERYL (LPC-MH, QMHP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:FEIOCK
Suffix:
Gender:F
Credentials:LPC-MH, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-4506
Mailing Address - Country:US
Mailing Address - Phone:605-222-9130
Mailing Address - Fax:
Practice Address - Street 1:110 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-4506
Practice Address - Country:US
Practice Address - Phone:605-222-9130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2283101YP2500X
SDLPC7252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health