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General NPI Number Information
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NPI Number | 1992901839
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Entity Type | Organization
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Legal Business Name | GREENTREE PSYCHOLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 W 3RD ST SUITE 203
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City | YANKTON
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State | SD
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Zip | 57078-4365
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Country | US
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Telephone | 605-668-2222
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Fax | 605-668-2222
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Provider Business Mailing Address
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Address Line | PO BOX 526
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City | YANKTON
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State | SD
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Zip | 57078-0526
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Country | US
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Telephone | 605-668-2222
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Fax | 605-668-2222
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ELIZABETHER SUMNER SPIVEY
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Credential | PH.D.
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Telephone | 605-668-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 260
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License Number State | SD
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