PSYCHODYNAMIC THERAPY NPI 1508504192

NPI Information

  • NPI: 1508504192
  • Provider Name: PSYCHODYNAMIC THERAPY
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 3610 S WESTERN AVE STE 2
    SIOUX FALLS, SD
    ZIP 57105
  • Phone: (605) 254-4789

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NPI Details

PSYCHODYNAMIC THERAPY is a professional counselor in Sioux Falls, SD. PSYCHODYNAMIC THERAPY NPI is 1508504192. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3610 S WESTERN AVE STE 2
SIOUX FALLS, SD
ZIP 57105-143
Phone: (605) 254-4789

The provider's authorized official is Irina Goubanova .
The authorized official title is Lpc and has the following contact phone number (605) 254-4789.

The enumeration date for this NPI number is 5/24/2022 and was last updated on 5/24/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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