| Susan K Eleeson Inc | |
|
47143 299th St Beresford SD 57004 | |
| (605) 351-5826 | |
| Not Available |
| Full Name | Susan K Eleeson Inc |
|---|---|
| Speciality | Psychologist |
| Location | 47143 299th St, Beresford, South Dakota |
| Authorized Official Name and Position | Susan Kristine Eleeson (CEO/LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6053515826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan K Eleeson Inc 47143 299th St. Beresford SD 57004 Ph: (605) 351-5826 | Susan K Eleeson Inc 47143 299th St Beresford SD 57004 Ph: (605) 351-5826 |
| NPI Number | 1275903312 |
|---|---|
| Provider Enumeration Date | 10/01/2015 |
| Last Update Date | 02/01/2024 |
| Certification Date | 01/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275903312 | NPI | - | NPPES |
| 1568417657 | Medicaid | SD | |
| S107742 | Other | SD | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 399 (South Dakota) | Primary |