Provider Demographics
NPI:1700581782
Name:HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:605-413-8804
Mailing Address - Street 1:305 S GOLDEN WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-8829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 8TH AVE NE
Practice Address - Street 2:STE 135
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-3254
Practice Address - Country:US
Practice Address - Phone:605-413-8804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty