Provider Demographics
NPI:1447084025
Name:NANGLE, HEIDI (BA, ACT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:NANGLE
Suffix:
Gender:F
Credentials:BA, ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1520 HAINES AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-0710
Mailing Address - Country:US
Mailing Address - Phone:605-716-7841
Mailing Address - Fax:605-718-0404
Practice Address - Street 1:1520 HAINES AVE
Practice Address - Street 2:STE 6
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-0710
Practice Address - Country:US
Practice Address - Phone:605-716-7841
Practice Address - Fax:605-718-0404
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD8437103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)