| Sioux River Mental Health Services Llc | |
|
431 N Phillips Ave Ste 340 Sioux Falls SD 57104-5933 | |
| (605) 413-6957 | |
| Not Available |
| Full Name | Sioux River Mental Health Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 431 N Phillips Ave Ste 340, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Justin Falon (OWNER / PROVIDER) |
| Authorized Official Contact | 6054136957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sioux River Mental Health Services Llc 431 N Phillips Ave Ste 340 Sioux Falls SD 57104-5933 Ph: (605) 413-6957 | Sioux River Mental Health Services Llc 431 N Phillips Ave Ste 340 Sioux Falls SD 57104-5933 Ph: (605) 413-6957 |
| NPI Number | 1306310065 |
|---|---|
| Provider Enumeration Date | 01/16/2019 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/23/2024 |
| Medicare PECOS PAC ID | 3678017712 |
|---|---|
| Medicare Enrollment ID | O20240701002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306310065 | NPI | - | NPPES |
| 833124997 | Other | SD | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Justin Lee Falon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528200219 PECOS PAC ID: 4587108626 Enrollment ID: I20240701002216 |
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