| Kristine Dejaeghere-tillett Counseling, Llc | |
|
3805 S Kiwanis Cir Ste 101 Sioux Falls SD 57105-4266 | |
| (605) 663-4600 | |
| Not Available |
| Full Name | Kristine Dejaeghere-tillett Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3805 S Kiwanis Cir Ste 101, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Kristine Dejaegherre-tillett (OWNER) |
| Authorized Official Contact | 6058818740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristine Dejaeghere-tillett Counseling, Llc 2528 S Center Ave Sioux Falls SD 57105-4814 Ph: (605) 881-8740 | Kristine Dejaeghere-tillett Counseling, Llc 3805 S Kiwanis Cir Ste 101 Sioux Falls SD 57105-4266 Ph: (605) 663-4600 |
| NPI Number | 1578210449 |
|---|---|
| Provider Enumeration Date | 03/09/2022 |
| Last Update Date | 03/09/2022 |
| Certification Date | 03/09/2022 |
| Medicare PECOS PAC ID | 9739602459 |
|---|---|
| Medicare Enrollment ID | O20250402002836 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578210449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kristine M Dejaeghere-tillett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780293159 PECOS PAC ID: 0648793364 Enrollment ID: I20250402002969 |
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