Healthcare Provider Details

I. General information

NPI: 1326121757
Provider Name (Legal Business Name): KIMBERLY JEAN LIGHTFIELD LPC-MH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY JEAN SCHULTZ LPC-MH

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 4TH ST NW
WATERTOWN SD
57201-1558
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 605-886-8471
  • Fax:
Mailing address:
  • Phone: 605-886-8471
  • Fax: 605-886-9317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-MH2155
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-MH2155
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: