Healthcare Provider Details

I. General information

NPI: 1538081518
Provider Name (Legal Business Name): REEGAN ELDER BA, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 S LOUISE AVE STE 201
SIOUX FALLS SD
57106-3124
US

IV. Provider business mailing address

4300 S LOUISE AVE STE 201
SIOUX FALLS SD
57106-3124
US

V. Phone/Fax

Practice location:
  • Phone: 605-334-7713
  • Fax:
Mailing address:
  • Phone: 605-334-7713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC21234SUPERVISEE
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: