Provider Demographics
NPI:1730800103
Name:CONRAD COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:CONRAD COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:605-361-8876
Mailing Address - Street 1:7401 S BITTERROOT PL STE 303
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-1610
Mailing Address - Country:US
Mailing Address - Phone:605-361-8876
Mailing Address - Fax:605-361-8876
Practice Address - Street 1:7401 S BITTERROOT PL STE 303
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-1610
Practice Address - Country:US
Practice Address - Phone:605-361-8876
Practice Address - Fax:605-361-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty