Bristow, Boyd A

Bristow, Boyd A is an individual health care provider with primary practice located at 523 N Duluth Ave , Sioux Falls SD 57104-2714. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Bristow, Boyd A can be contacted via phone (605) 988-3775.

Contact Information

Primary practice address
523 N Duluth Ave Sioux Falls SD 57104-2714
Phone: (605) 988-3775
Fax: (605) 988-3747
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-MH 2052 South Dakota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LMFT 1170 South Dakota

Profile Details

NPI number 1457437915
LBN Legal business name Bristow, Boyd A
Credentials LPC-MH,QMHP,LMFT,MA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457437915 NPPES
South Dakota Other 4998932 BCBS
South Dakota MEDICAID 6575340 BCBS

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