Healthcare Provider Details

I. General information

NPI: 1528982881
Provider Name (Legal Business Name): AMBER THEIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CENTRAL AVE NW STE 300
ORANGE CITY IA
51041-1332
US

IV. Provider business mailing address

400 S SYCAMORE AVE STE 105-3
SIOUX FALLS SD
57110-1255
US

V. Phone/Fax

Practice location:
  • Phone: 712-737-2635
  • Fax: 712-737-2344
Mailing address:
  • Phone: 605-334-3739
  • Fax: 605-334-7752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120387
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: