Provider Demographics
NPI:1205900149
Name:BATCHELOR, JUDITH (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W LYNCREST TRL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3812
Mailing Address - Country:US
Mailing Address - Phone:605-357-8549
Mailing Address - Fax:
Practice Address - Street 1:122 S PHILLIPS AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6717
Practice Address - Country:US
Practice Address - Phone:605-367-9080
Practice Address - Fax:605-339-9270
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD13541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4153Medicare ID - Type Unspecified