Provider Demographics
NPI:1962019976
Name:BREAKTHROUGH COUNSELING, LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDE LUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-906-2171
Mailing Address - Street 1:1701 E 69TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8317
Mailing Address - Country:US
Mailing Address - Phone:605-906-2171
Mailing Address - Fax:
Practice Address - Street 1:1701 E 69TH ST STE A
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8317
Practice Address - Country:US
Practice Address - Phone:605-906-2171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty