Dornheim, Mary Beth

Dornheim, Mary Beth is an individual health care provider with primary practice located at 2400 W 49Th St , Sioux Falls SD 57105-6581. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dornheim, Mary Beth can be contacted via phone (605) 312-8700.

Contact Information

Primary practice address
2400 W 49Th St Sioux Falls SD 57105-6581
Phone: (605) 312-8700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 173889 Minnesota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4781 South Dakota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 19740 Minnesota

Profile Details

NPI number 1356487227
LBN Legal business name Dornheim, Mary Beth
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated May 28th, 2024 - about 7 months 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 1356487227 NPPES
Minnesota Other 330617000 MINNESOTA HEALTH CARE PROGRAMS
Minnesota Other 1356487227 MINNESOTA HEALTH CARE PROGRAMS
Minnesota Other 000498910 MINNESOTA HEALTH CARE PROGRAMS

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