Healthcare Provider Details

I. General information

NPI: 1669568200
Provider Name (Legal Business Name): SHERRY LEA BARTELS MA, LPC, CCDCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 W 41ST ST SUITE 203
SIOUX FALLS SD
57105-4221
US

IV. Provider business mailing address

3101 W 41ST ST SUITE 203
SIOUX FALLS SD
57105-4221
US

V. Phone/Fax

Practice location:
  • Phone: 605-310-0032
  • Fax: 605-271-0200
Mailing address:
  • Phone: 605-310-0032
  • Fax: 605-271-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number04071198
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC1040
License Number StateSD

VII. Legacy identifiers

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

# 1
Identifier5000340
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: