Provider Demographics
NPI:1891469755
Name:BRG COUNSELING LLC
Entity Type:Organization
Organization Name:BRG COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENEICH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC-MH
Authorized Official - Phone:605-467-7424
Mailing Address - Street 1:4900 S MINNESOTA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2865
Mailing Address - Country:US
Mailing Address - Phone:605-467-7424
Mailing Address - Fax:
Practice Address - Street 1:4900 S MINNESOTA AVE STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2865
Practice Address - Country:US
Practice Address - Phone:605-467-7424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD2020018Medicaid