Healthcare Provider Details

I. General information

NPI: 1215851910
Provider Name (Legal Business Name): NICOLE MELISSA REISER CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 W 41ST ST STE 204
SIOUX FALLS SD
57106-1300
US

IV. Provider business mailing address

5421 W 41ST ST STE 204
SIOUX FALLS SD
57106-1300
US

V. Phone/Fax

Practice location:
  • Phone: 605-709-4640
  • Fax: 605-306-3214
Mailing address:
  • Phone: 605-709-4640
  • Fax: 605-306-3214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7109
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: