Healthcare Provider Details

I. General information

NPI: 1265128508
Provider Name (Legal Business Name): KATHERINE WOUDSTRA PSY.D., LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E 69TH ST STE A
SIOUX FALLS SD
57108-8331
US

IV. Provider business mailing address

3100 S GROVELAND DR
SIOUX FALLS SD
57110-6000
US

V. Phone/Fax

Practice location:
  • Phone: 605-275-2280
  • Fax:
Mailing address:
  • Phone: 954-707-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: