Provider Demographics
NPI:1447534409
Name:SALMEN, LATANDA MORGAN (CSWPIP)
Entity type:Individual
Prefix:
First Name:LATANDA
Middle Name:MORGAN
Last Name:SALMEN
Suffix:
Gender:F
Credentials:CSWPIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 W VALHALLA BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3747
Mailing Address - Country:US
Mailing Address - Phone:605-360-5051
Mailing Address - Fax:605-854-5833
Practice Address - Street 1:4001 W VALHALLA BLVD
Practice Address - Street 2:STE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3747
Practice Address - Country:US
Practice Address - Phone:605-360-5051
Practice Address - Fax:605-854-5833
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD31531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447534409OtherDAKOTACARE
1447534409OtherDAKOTACARE