Healthcare Provider Details

I. General information

NPI: 1578440772
Provider Name (Legal Business Name): KELSEY JEAN HOLZBAUER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 S NORTON AVE STE 2835
SIOUX FALLS SD
57105-2835
US

IV. Provider business mailing address

2020 S NORTON AVE STE 2835
SIOUX FALLS SD
57105-2835
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-3061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6866
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: