Healthcare Provider Details

I. General information

NPI: 1659642668
Provider Name (Legal Business Name): CHERYL FEIOCK LPC-MH, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2012
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W MISSOURI AVE
PIERRE SD
57501-4506
US

IV. Provider business mailing address

110 W MISSOURI AVE
PIERRE SD
57501-4506
US

V. Phone/Fax

Practice location:
  • Phone: 605-222-9130
  • Fax:
Mailing address:
  • Phone: 605-222-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC7252
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-MH2283
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: