Provider Demographics
NPI:1720658966
Name:JANE WEBSTER LLC
Entity Type:Organization
Organization Name:JANE WEBSTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPCMH LAC QMHP
Authorized Official - Phone:605-261-0819
Mailing Address - Street 1:2000 S SYCAMORE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4263
Mailing Address - Country:US
Mailing Address - Phone:605-261-0819
Mailing Address - Fax:605-271-0263
Practice Address - Street 1:2000 S SYCAMORE AVE STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4263
Practice Address - Country:US
Practice Address - Phone:605-261-0819
Practice Address - Fax:605-271-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty