Healthcare Provider Details

I. General information

NPI: 1053238691
Provider Name (Legal Business Name): JAY TRENHALE LP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 CYPRESS POINT CIR
BROOKINGS SD
57006-5451
US

IV. Provider business mailing address

306 4TH ST # 113
BROOKINGS SD
57006-1948
US

V. Phone/Fax

Practice location:
  • Phone: 320-634-6599
  • Fax:
Mailing address:
  • Phone: 320-634-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number386383
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number394
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: