Provider Demographics
NPI:1831251172
Name:PIACENTINO, MARIA D (MA,LPC-MH,LAC, QMHP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:PIACENTINO
Suffix:
Gender:F
Credentials:MA,LPC-MH,LAC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 S CARNEGIE CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2321
Mailing Address - Country:US
Mailing Address - Phone:605-310-2426
Mailing Address - Fax:
Practice Address - Street 1:4109 S CARNEGIE CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2321
Practice Address - Country:US
Practice Address - Phone:605-310-2426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD9704947101YA0400X
SDLPC101YP2500X
2212101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional