Kimberly A Haugen, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

653 Issued in SD

Practice address

901 4TH St NW
Watertown, SD 57201-1558

Phone

(605) 866-8471

NPI assigned

Apr 19, 2007

Last updated

May 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kimberly Deruyck Former name

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Sanford Medical Center

  dba Edith Sanford Breast Specialty Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342
  Medicare reassignment NPD
• Bridgeway Counseling Center Inc.

  dba Bridgeway Counseling and Neuropsychology

  • Psychologist
  • Watertown, SD
  • NPI 1326277625
  NPD
• Sanford Medical Center

  dba Sanford Clinic Estelline

  • Rural Health Clinic/Center
  • Estelline, SD
  • NPI 1548230683
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1194942482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 4TH ST NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011558",
            "telephone_number": "605-866-8471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 3rd Ave NW",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572012311",
            "country_code": "US",
            "telephone_number": "605-886-5262",
            "fax_number": "605-886-5228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "281",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660631",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47037660639",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DERUYCK",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chad Jerome Hanson, MSPT ATC
• Jeffrey W Hanson, MD
• Farah N Haque, M.D.
• Mackenzie Hardie, PT
• Nicholas John Harms, M.D.
• Gwen Louise Hawley Holinka, OTR/L
• Michael John Hawley, DDS MS
• Stephanie Hayunga, OTR/L
• Heal Harbor LLC
• Healthfirst Chiropractic of Watertown

• Psychologist in Watertown, SD
• Providers in Watertown, SD by specialty
• Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.