NPIMap

Craig J.P. Kindrat, LPC, LMFT, CCDCIII

Individual provider Active NPI Marriage & Family Therapist · Sioux Falls, SD

NPI 1154483667 · NPPES record last updated Apr 13, 2009

Key facts

NPI
1154483667
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMFT 1042 (SD)
Practice address
2412 S Cliff Ave
Suite 100
Sioux Falls, SD 57105-4031
Phone
(605) 322-4079
Fax
(605) 322-4080
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CCDCIII-01081179SDMDAddiction (Substance Use Disorder) Counselor
LPC 741SDMDProfessional Counselor
LMFT 1042SDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CCDCIII-01081179 SD
Professional Counselor 101YP2500X LPC 741 SD
Marriage & Family Therapist 106H00000X LMFT 1042 SD Yes

Addresses

Primary practice location

2412 S Cliff Ave
Suite 100
Sioux Falls, SD 57105-4031

Mailing address

2412 S Cliff Ave
Suite 100
Sioux Falls, SD 57105-4031
Phone (605) 322-4079

Other identifiers

IdentifierTypeStateIssuer
31005800MedicaidMN

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Marriage & Family Therapist in South Dakota

Sources for this page

Verify at the official NPI Registry.