Provider Demographics
NPI:1699002824
Name:FRIEST, EILEEN DALA (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:DALA
Last Name:FRIEST
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S. MAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4905
Mailing Address - Country:US
Mailing Address - Phone:605-254-6611
Mailing Address - Fax:
Practice Address - Street 1:615 S. MAIN AVENUE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4905
Practice Address - Country:US
Practice Address - Phone:605-254-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC796101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor