1740526870 NPI number — DR. FRANK O. MAIN JR. ED.D, LMFT

Table of content: DR. FRANK O. MAIN JR. ED.D, LMFT (NPI 1740526870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740526870 NPI number — DR. FRANK O. MAIN JR. ED.D, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAIN
Provider First Name:
FRANK
Provider Middle Name:
O.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
ED.D, LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740526870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 VALLEY VIEW DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERMILLION
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-624-2508
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4300 LOUISE AVENUE #201
Provider Second Line Business Practice Location Address:
STRONGHOLD COUNSELING SERVICES
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-334-7713
Provider Business Practice Location Address Fax Number:
605-334-5348
Provider Enumeration Date:
12/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  SD.LMFT#1051 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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