NPIMap

Organization Active NPI

Bethesda Christian Counseling Midwest, Inc.

Doing business as Bethesda Christian Counseling

  • Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1376522060
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2080 Issued in SD
Legal business name
BETHESDA CHRISTIAN COUNSELING MIDWEST, INC.
Doing business as
Bethesda Christian Counseling
Bethesda Christian Counseling Midwest
Practice address
400 S Sycamore Ave Ste 105-3
Sioux Falls, SD 57110-1255
Phone
(605) 334-3739
Fax
(605) 334-7752
NPI assigned
Jan 11, 2006
Last updated
Aug 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Ms. Stacey A Eeten
Title
Credentialing Coordinator
Phone
(605) 334-3739

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 00291 IA
Mental Health Counselor 101YM0800X 001072 IA
Mental Health Counselor 101YM0800X 001696 IA
Professional Counselor 101YP2500X 7288 SD
Psychologist 103T00000X LP2939 MN
Psychologist 103T00000X 446 SD
Social Worker 104100000X 673 SD
Social Worker 104100000X 947 SD
Social Worker 104100000X 06042 IA
Clinical Social Worker 1041C0700X 085016 IA
Clinical Social Worker 1041C0700X 086471 SD
Psychiatry Physician 2084P0800X 27059 IA
Psychiatry Physician 2084P0800X 2080 SD Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

400 S Sycamore Ave Ste 105-3
Sioux Falls, SD 57110-1255

Mailing address

400 S Sycamore Ave
Suite 105-3
Sioux Falls, SD 57110-1246
Phone (605) 334-3739

Other practice location 1

400 Central Ave NW Ste 300
Orange City, IA 51041-1332
Phone (712) 737-2635

Other practice location 2

215 N Cedar St
Luverne, MN 56156-1626
Phone (800) 463-4005

Other identifiers 2

IdentifierTypeStateIssuer
0004414OtherSDBC BS OF SOUTH DAKOTA
28524BEOtherSDBC BS OF MINNESOTA

Other names 2

  • Bethesda Christian Counseling Doing business as
  • Bethesda Christian Counseling Midwest Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040403000259 IA Part B Supplier - Clinic/Group Practice 6608869078 Receives reassigned benefits from 6 practitioners
Practice locations: Orange City, IA
O20040420001222 SD Part B Supplier - Clinic/Group Practice 6608869078 Receives reassigned benefits from 5 practitioners
Practice locations: Sioux Falls, SD
O20240222003867 MN Part B Supplier - Clinic/Group Practice 6608869078 Receives reassigned benefits from 1 practitioner
Practice locations: Luverne, MN

National Provider Directory

National Provider Directory

Locations

209 1st St NE
#103
Orange City, IA 51041
Phone (712) 737-2635

400 Central Ave NW
Ste 300
Orange City, IA 51041
Phone (712) 737-2635

215 N Cedar St
Luverne, MN 56156
Phone (507) 449-6145

400 S Sycamore Ave
Ste 105-3
Sioux Falls, SD 57110
Phone (605) 334-3739

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1376522060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S SYCAMORE AVE",
            "address_2": "SUITE 105-3",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571101246",
            "telephone_number": "605-334-3739",
            "fax_number": "605-334-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S SYCAMORE AVE STE 105-3",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571101255",
            "telephone_number": "605-334-3739",
            "fax_number": "605-334-7752"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Central Ave NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Orange City",
            "state": "IA",
            "postal_code": "510411332",
            "country_code": "US",
            "telephone_number": "712-737-2635",
            "fax_number": "712-737-2344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 N Cedar St",
            "address_purpose": "LOCATION",
            "city": "Luverne",
            "state": "MN",
            "postal_code": "561561626",
            "country_code": "US",
            "telephone_number": "800-463-4005",
            "fax_number": "605-334-7752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BETHESDA CHRISTIAN COUNSELING MIDWEST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "EETEN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "605-334-3739",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "00291",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001072",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001696",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "7288",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2939",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "446",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "673",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "947",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "06042",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "085016",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "086471",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "27059",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "2080",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF SOUTH DAKOTA",
            "identifier": "0004414",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MINNESOTA",
            "identifier": "28524BE",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethesda Christian Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bethesda Christian Counseling Midwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.