Healthcare Provider Details

I. General information

NPI: 1124962683
Provider Name (Legal Business Name): KRYSTAL K. PAULSON MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43159 SD HIGHWAY 52
YANKTON SD
57078-6719
US

IV. Provider business mailing address

43159 SD HIGHWAY 52
YANKTON SD
57078-6719
US

V. Phone/Fax

Practice location:
  • Phone: 605-660-5229
  • Fax:
Mailing address:
  • Phone: 605-660-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC20957
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: