Psychodynamic Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PSYCHODYNAMIC THERAPY

Practice address

3610 S Western Ave Ste 2
Sioux Falls, SD 57105-6143

Phone

(605) 254-4789

NPI assigned

May 24, 2022

Last updated

May 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Irina Goubanova

Title

LPC

Phone

(605) 254-4789

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1508504192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 S WESTERN AVE STE 2",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056143",
            "telephone_number": "605-254-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 S WESTERN AVE STE 2",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056143",
            "telephone_number": "605-254-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHODYNAMIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "GOUBANOVA",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "605-254-4789"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Prouty
• Mitchell Ray Pruett
• Ann Marie Pruitt
• Amber Lynn Pruner, M.A. CF-SLP
• Jacob Paul Prunuske, MD, MSPH
• Psychology Associates,Inc.
• Linda Mae Pudenz, CNS, RN
• Alexandra Anne Pudwill, CRNA
• Allan N Pudwill, CRNA
• Christopher Pudwill, CSW

• Professional Counselor in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Professional Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.