Healthcare Provider Details

I. General information

NPI: 1750788303
Provider Name (Legal Business Name): NANCY SPRYNCZYNATYK LPC-MH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N 7TH ST STE 6
SPEARFISH SD
57783-2710
US

IV. Provider business mailing address

115 N 7TH ST STE 6
SPEARFISH SD
57783-2710
US

V. Phone/Fax

Practice location:
  • Phone: 605-645-0100
  • Fax: 605-717-1009
Mailing address:
  • Phone: 605-645-0100
  • Fax: 605-717-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-MH2108
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-MH2108
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: