Healthcare Provider Details

I. General information

NPI: 1326607367
Provider Name (Legal Business Name): SHEYENNE GRACE BOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEYENNE GRACE HALSTENGARD

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NORTH ST
RAPID CITY SD
57701-1163
US

IV. Provider business mailing address

111 NORTH ST
RAPID CITY SD
57701-1163
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-0650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6813
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: