Healthcare Provider Details

I. General information

NPI: 1679574578
Provider Name (Legal Business Name): HEARTLAND PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 W 23RD ST SUITE 101
YANKTON SD
57078-1216
US

IV. Provider business mailing address

904 W 23RD ST SUITE 101
YANKTON SD
57078-1216
US

V. Phone/Fax

Practice location:
  • Phone: 605-665-0841
  • Fax: 605-665-0096
Mailing address:
  • Phone: 605-665-0841
  • Fax: 605-665-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2118
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2127
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number250
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number456
License Number StateSD
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number401
License Number StateSD
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1845
License Number StateSD

VIII. Authorized Official

Name: JOSEPH G BLACKINTON
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 605-665-0841