Brenda Michelle Lindsay Nour, PH.D.
Individual provider Active NPI Clinical Psychologist · Sioux Falls, SD
NPI 1073840260 · NPPES record last updated Oct 11, 2018
Key facts
- NPI
- 1073840260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3365 (CO)
- Practice address
- 4400 W 69TH St Ste 1500
Sioux Falls, SD 57108-8171 - Phone
- (605) 480-1482
- NPI assigned
- Nov 9, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100212000440 | SD | Practitioner - Clinical Psychologist | 1759425879 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3365 | CO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current | Accepting new patients |
Interoperability endpoints
- brenda.nour@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3365 | CO | Yes |
Addresses
Primary practice location
4400 W 69TH St Ste 1500
Sioux Falls, SD 57108-8171
Mailing address
4400 W 69TH St Ste 1500
Sioux Falls, SD 57108-8171
Phone (605) 480-1482
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6550210 | Medicaid | SD |
Other providers in Sioux Falls, SD
- Northland Hearing Centers, Inc.
- Northland Hearing Centers, Inc.
- Sonja Marie Northrup-Olson
- Northwestern Living LLC
- Norton SD Skilled Nursing Facility LLC
- Katie Nour
- Houman Nourkeyhani
- Amanda L Novak
- Christohper M Novak
- Eric James Novak
All providers in Sioux Falls, SD · Clinical Psychologist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.