Healthcare Provider Details

I. General information

NPI: 1710871082
Provider Name (Legal Business Name): KARI KOISTINEN CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 COMANCHE RD
FORT MEADE SD
57741-1002
US

IV. Provider business mailing address

607 SILVERLEAF DR
SPEARFISH SD
57783-3234
US

V. Phone/Fax

Practice location:
  • Phone: 605-347-2511
  • Fax:
Mailing address:
  • Phone: 612-741-2705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number6851
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: