Healthcare Provider Details

I. General information

NPI: 1609534676
Provider Name (Legal Business Name): AMANDA L NOVAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA L PARSONS LMSW

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 22ND ST
SIOUX FALLS SD
57105-1305
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-3230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107621
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: