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:
Health care specialties
| Specialty | Code | License # | 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 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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