| Lori Evenson | |
|
5000 S Broadband Ln Ste 119 Sioux Falls SD 57108-2261 | |
| (605) 777-0075 | |
| (888) 977-2561 |
| Full Name | Lori Evenson |
|---|---|
| Speciality | Counselor |
| Location | 5000 S Broadband Ln Ste 119, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Lori Evenson (OWNER) |
| Authorized Official Contact | 6057770075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Evenson 5000 S Broadband Ln Ste 119 Sioux Falls SD 57108-2261 Ph: (605) 777-0075 | Lori Evenson 5000 S Broadband Ln Ste 119 Sioux Falls SD 57108-2261 Ph: (605) 777-0075 |
| NPI Number | 1194499780 |
|---|---|
| Provider Enumeration Date | 08/06/2021 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Medicare PECOS PAC ID | 3274902820 |
|---|---|
| Medicare Enrollment ID | O20221205000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194499780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Chelsea A Oppold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265096739 PECOS PAC ID: 4981937018 Enrollment ID: I20190605000963 |
| Provider Name | Jessica L Olson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790471142 PECOS PAC ID: 5890138796 Enrollment ID: I20240207003862 |
| Provider Name | Lori Evenson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174995112 PECOS PAC ID: 1456720002 Enrollment ID: I20240208001793 |
| Provider Name | Richard Culver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538874409 PECOS PAC ID: 8820432818 Enrollment ID: I20240217000731 |
| Provider Name | Miles Fischer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992570840 PECOS PAC ID: 8224473780 Enrollment ID: I20240223003993 |
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