Bethesda Christian Counseling Midwest | |
400 S Sycamore Ave Ste 105-3 Sioux Falls SD 57110-1255 | |
(605) 334-3739 | |
(605) 334-7752 |
Full Name | Bethesda Christian Counseling Midwest |
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Speciality | Psychiatry & Neurology |
Location | 400 S Sycamore Ave Ste 105-3, Sioux Falls, South Dakota |
Authorized Official Name and Position | Stacey A Eeten (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 6053343739 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bethesda Christian Counseling Midwest 400 S Sycamore Ave Suite 105-3 Sioux Falls SD 57110-1246 Ph: (605) 334-3739 | Bethesda Christian Counseling Midwest 400 S Sycamore Ave Ste 105-3 Sioux Falls SD 57110-1255 Ph: (605) 334-3739 |
NPI Number | 1376522060 |
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Provider Enumeration Date | 01/11/2006 |
Last Update Date | 08/12/2021 |
Certification Date | 08/12/2021 |
Medicare PECOS PAC ID | 6608869078 |
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Medicare Enrollment ID | O20040403000259 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376522060 | NPI | - | NPPES |
28524BE | Other | SD | BC BS OF MINNESOTA |
0004414 | Other | SD | BC BS OF SOUTH DAKOTA |
Provider Name | William Lynn Huisken |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1174525190 PECOS PAC ID: 3173648177 Enrollment ID: I20100914001212 |
Provider Name | Mandi Dolieslager |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053831586 PECOS PAC ID: 4486080918 Enrollment ID: I20200131002228 |
Provider Name | Tammy Jo Vande Kamp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427417898 PECOS PAC ID: 4981947595 Enrollment ID: I20220224000906 |
Provider Name | Melody Deanne Becker Pullman |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1891853750 PECOS PAC ID: 5294185708 Enrollment ID: I20231226001140 |
Provider Name | Deon J Wynia |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1720187867 PECOS PAC ID: 0648620161 Enrollment ID: I20231226001541 |
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