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NPI Code Detail

MEDICARE: HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC

MEDICARE: HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1700581782
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC
Provider Business Mailing Address
First Line : 305 S GOLDEN WILLOW AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57110-8829
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 634 S ROOSEVELT ST STE 4
Second Line :
City : ABERDEEN
State : SD
Zip : 57401-6593
Country : US
Telephone Number : 605-366-1228
Fax Number : 605-401-4104
Authorized Official
Title or Position : LICENSED PSYCHOLOGIST
Name : DR. AMANDA JEAN REED
Credential : PHD
Telephone Number : 605-366-1228
Provider Enumeration Date : 03/31/2023
Last Update Date : 09/14/2024

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Directions to “HEALING BRIDGE PSYCHOLOGICAL SERVICES LLC ” Practice Location

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