Active NPI
Andrea Katherine Medema, LPC
- Professional Counselor
- Sioux Falls, SD
National Provider Identifier
1376836023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC7175
- Practice address
- 3801 S Kiwanis Ave
Suite 5
Sioux Falls, SD 57105-4200 - Phone
- (605) 323-8001
- NPI assigned
- May 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC7175 | SD | Primary |
Addresses
Primary practice location
3801 S Kiwanis Ave
Suite 5
Sioux Falls, SD 57105-4200
Mailing address
3801 S Kiwanis Ave
Suite 5
Sioux Falls, SD 57105-4200
Phone (605) 323-8001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC7175 | Other | SD | LPC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC7175 | SD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1376836023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 S KIWANIS AVE",
"address_2": "SUITE 5",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054200",
"telephone_number": "605-323-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 S KIWANIS AVE",
"address_2": "SUITE 5",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054200",
"telephone_number": "605-323-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDEMA",
"first_name": "ANDREA",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-26",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SD",
"license": "LPC7175",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "LPC7175",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}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 Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.