Healthcare Provider Details

I. General information

NPI: 1558742569
Provider Name (Legal Business Name): ANGIE KAYE OSTRAAT LPC-MH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46560 264TH ST
SIOUX FALLS SD
57107-6903
US

IV. Provider business mailing address

1110 E 77TH ST
SIOUX FALLS SD
57108-3020
US

V. Phone/Fax

Practice location:
  • Phone: 605-528-3550
  • Fax: 605-528-3559
Mailing address:
  • Phone: 605-275-0009
  • Fax: 877-992-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-MH2295
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC7305
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: