Provider Demographics
NPI:1669568200
Name:BARTELS, SHERRY LEA (MA, LPC, CCDCIII)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEA
Last Name:BARTELS
Suffix:
Gender:F
Credentials:MA, LPC, CCDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 W 41ST ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4221
Mailing Address - Country:US
Mailing Address - Phone:605-310-0032
Mailing Address - Fax:605-271-0200
Practice Address - Street 1:3101 W 41ST ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4221
Practice Address - Country:US
Practice Address - Phone:605-310-0032
Practice Address - Fax:605-271-0200
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD04071198101YA0400X
SDLPC1040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5000340Medicaid