Healthcare Provider Details

I. General information

NPI: 1265096739
Provider Name (Legal Business Name): CHELSEA OPPOLD CSW, MSW-PIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5024 S BUR OAK PL STE 208
SIOUX FALLS SD
57108-2238
US

IV. Provider business mailing address

5024 S BUR OAK PL STE 208
SIOUX FALLS SD
57108-2238
US

V. Phone/Fax

Practice location:
  • Phone: 605-305-2132
  • Fax: 605-274-3111
Mailing address:
  • Phone: 605-305-2132
  • Fax: 605-274-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6122
License Number StateSD

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: