Healthcare Provider Details

I. General information

NPI: 1508474727
Provider Name (Legal Business Name): PRAIRIE SKIES PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 BROADWAY AVE STE 13
YANKTON SD
57078-7800
US

IV. Provider business mailing address

905 W 10TH ST
YANKTON SD
57078-3415
US

V. Phone/Fax

Practice location:
  • Phone: 605-661-0095
  • Fax:
Mailing address:
  • Phone: 605-661-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICK MESSLER
Title or Position: FOUNDER AND OWNER
Credential:
Phone: 605-661-0095