Provider Demographics
NPI:1023756699
Name:TAYLER HOOGEVEEN
Entity type:Organization
Organization Name:TAYLER HOOGEVEEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOGEVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CSW, QMHP
Authorized Official - Phone:507-227-5266
Mailing Address - Street 1:5024 S BUR OAK PL STE 208
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2238
Mailing Address - Country:US
Mailing Address - Phone:507-227-5266
Mailing Address - Fax:
Practice Address - Street 1:5024 S BUR OAK PL STE 208
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2238
Practice Address - Country:US
Practice Address - Phone:507-227-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty