DR. TRACY J STEPHENS (NPI# 1114180064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114180064 |
Entity Type | Individual |
Full Name | DR. TRACY J STEPHENS |
Credential | PH,D., BCBA |
Practice Address |
1105 W Russell Street Sioux Falls SD 57104 |
Mailing Address |
1105 W Russell St Sioux Falls SD 57104-1322 |
Practice Telephone | 6052712690 |
Practice Fax Number | 6052713956 |
Mailing Telephone | 6052712690 |
Mailing Fax Number | 6052713956 |
Enumeration Date | 2008-07-09 |
Last Update Date | 2017-01-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103T00000X | Psychologist | 419 | SD | Behavioral Health & Social Service Providers |
Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SD | 6551930 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295269892 | Tracy Stephens | Social Worker | 1002 N Superior St, Spokane, WA 99202-2059 | 2017-04-20 |
1427253947 | Tracy Stephens | Speech-Language Pathologist | 401 South Main, Diamond, MO 64840 | 2007-06-15 |
1568664142 | Tracy Louise Stephens | Nurse Practitioner | 1500 James Simpson Jr Way, Covington, KY 41011-0801 | 2007-06-05 |
Street Address |
1105 W RUSSELL STREET |
City | SIOUX FALLS |
State | SD |
Zip Code | 57104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
Find all providers in zip 57104 |
Taxonomy Code | 103TB0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Cognitive & Behavioral |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518055078 | Thomas L. Price | Psychologist | 6810 S Lyncrest Ave, Suite 201, Sioux Falls, SD 57108-2515 | 2006-10-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316915697 | Laura W Hughes | Psychologist | 2908 Fifth Street, Rapid City, SD 57701 | 2006-03-10 |
1386120335 | Lindsay Mae Miller | Psychologist | 3625 5th St, Rapid City, SD 57701-6015 | 2018-07-12 |
1699730804 | James Parker | Psychologist | 1201 Hwy 71 S., Hot Springs, SD 57747 | 2006-04-19 |
City | SIOUX FALLS |
Zip Code | 57104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.