Provider Demographics
NPI:1336764653
Name:TERVEEN COUNSELING LLC
Entity Type:Organization
Organization Name:TERVEEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TERVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC-MH
Authorized Official - Phone:605-641-2977
Mailing Address - Street 1:127 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2924
Mailing Address - Country:US
Mailing Address - Phone:605-641-2977
Mailing Address - Fax:
Practice Address - Street 1:1320 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1525
Practice Address - Country:US
Practice Address - Phone:605-644-7452
Practice Address - Fax:605-644-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1700013091Medicaid