| Starfish, Llc | |
|
4301 W 57th St Ste 100 Sioux Falls SD 57108-2255 | |
| (605) 335-1516 | |
| Not Available |
| Full Name | Starfish, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4301 W 57th St Ste 100, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Amanda A Vander Lugt (OWNER) |
| Authorized Official Contact | 4144919530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Starfish, Llc 709 W Sterling Oak Cir Sioux Falls SD 57108-4101 Ph: (414) 491-9530 | Starfish, Llc 4301 W 57th St Ste 100 Sioux Falls SD 57108-2255 Ph: (605) 335-1516 |
| NPI Number | 1871374116 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 1951745892 |
|---|---|
| Medicare Enrollment ID | O20240219001817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871374116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Amanda C Adcock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740521855 PECOS PAC ID: 9638475262 Enrollment ID: I20240405000991 |
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