Provider Demographics
NPI:1174525190
Name:HUISKEN, WILLIAM L (LCSW PIP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:L
Last Name:HUISKEN
Suffix:
Gender:M
Credentials:LCSW PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S SYCAMORE AVE
Mailing Address - Street 2:SUITE 105-3
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-1246
Mailing Address - Country:US
Mailing Address - Phone:605-334-3739
Mailing Address - Fax:605-334-7752
Practice Address - Street 1:400 S SYCAMORE AVE
Practice Address - Street 2:SUITE 105-3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-1246
Practice Address - Country:US
Practice Address - Phone:605-334-3739
Practice Address - Fax:605-334-7752
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLCSW-PIP #947104100000X
IALISW#06042104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA363854095Medicaid
SD6570082Medicaid
SD6570082Medicaid
IA363854095Medicaid