Healthcare Provider Details

I. General information

NPI: 1891618716
Provider Name (Legal Business Name): SUNSPIRE INTEGRATIVE THERAPY AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5112 W 55TH STREET
SIOUX FALLS SD
57106
US

IV. Provider business mailing address

5013 S LOUISE AVE # 336
SIOUX FALLS SD
57108-2268
US

V. Phone/Fax

Practice location:
  • Phone: 605-610-8199
  • Fax:
Mailing address:
  • Phone: 605-610-8199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KYLA PETERSON
Title or Position: CLINICAL SOCIAL WORKER
Credential: CSW-PIP
Phone: 605-610-8199