Linda K Vande Weerd
Individual provider Active NPI Professional Counselor · Brookings, SD
NPI 1821060302 · NPPES record last updated Jun 22, 2015
Key facts
- NPI
- 1821060302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC MH 2040 (SD)
- Practice address
- 922 4TH St
Suite a
Brookings, SD 57006-2173 - Phone
- (605) 692-6444
- Fax
- (605) 692-8997
- NPI assigned
- Feb 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9804992 | SD | MD | Addiction (Substance Use Disorder) Counselor |
| LPC MH 2040 | SD | MD | Professional Counselor |
| RO15085 | SD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Rivers, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9804992 | SD | |
| Professional Counselor | 101YP2500X | LPC MH 2040 | SD | Yes |
| Marriage & Family Therapist | 106H00000X | LMFT 1137 | ||
| Registered Nurse | 163W00000X | RO15085 | SD |
Addresses
Primary practice location
922 4TH St
Suite a
Brookings, SD 57006-2173
Mailing address
922 4TH St
Suite a
Brookings, SD 57006-2173
Phone (605) 692-6444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4997874 | Other | SD | BCBS |
| 6575272 | Medicaid | SD |
Other providers in Brookings, SD
- Andrea Uckert
- United Retirement Center
- Hillary Van Dyke
- Gary Cornelius Van Riper
- Rebecca Vande Kop
- Katy J Vanderwal
- Abigail Joy Vanliere
- Richard A. Wake
- Victoria Wakeman
- Wal-Mart Stores, Inc.
All providers in Brookings, SD · Professional Counselor in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.