Healthcare Provider Details

I. General information

NPI: 1073676631
Provider Name (Legal Business Name): MARY C MAYRAND-STERNHAGEN LPC MH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HEARTLAND PSYCHOLOGICAL SERVICES 904 W 23RD ST STE 101
YANKTON SD
57078
US

IV. Provider business mailing address

HEARTLAND PSYCHOLOGICAL SERVICES 904 W 23RD ST STE 101
YANKTON SD
57078
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 TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-MH2118
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: