Provider Demographics
NPI:1558742569
Name:OSTRAAT, ANGIE KAYE (LPC-MH)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:KAYE
Last Name:OSTRAAT
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E 77TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3020
Mailing Address - Country:US
Mailing Address - Phone:605-275-0009
Mailing Address - Fax:877-992-0016
Practice Address - Street 1:46560 264TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57107-6903
Practice Address - Country:US
Practice Address - Phone:605-528-3550
Practice Address - Fax:605-528-3559
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7305101YP2500X
SDLPC-MH2295101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional