Wyatt Lawrence Urlacher, LCSW-PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5139 Issued in SD

Practice address

1200 N West Ave
Sioux Falls, SD 57104-1335

Phone

(605) 339-0420

Fax

(605) 339-0038

NPI assigned

Jan 3, 2019

Last updated

Nov 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wyatt Urlacher Psychotherapy

  • Clinical Social Worker
  • Brandon, SD
  • NPI 1316766025
  NPD Authorized official
• Wyatt Urlacher Psychotherapy

  • Clinical Social Worker
  • Brandon, SD
  • NPI 1740008184
  NPD (past) Authorized official

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1457824344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571041335",
            "telephone_number": "605-339-0420",
            "fax_number": "605-339-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571041335",
            "telephone_number": "605-339-0420",
            "fax_number": "605-339-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W Birchwood Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "SD",
            "postal_code": "570052107",
            "country_code": "US",
            "telephone_number": "605-519-3588",
            "fax_number": "605-599-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URLACHER",
        "first_name": "WYATT",
        "middle_name": "LAWRENCE",
        "credential": "LCSW-PIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "5139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Clinical Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.