Provider Demographics
NPI:1578931515
Name:STRUBBE, VIRGINIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:STRUBBE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26547 461ST AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:SD
Mailing Address - Zip Code:57033-6701
Mailing Address - Country:US
Mailing Address - Phone:605-661-6906
Mailing Address - Fax:
Practice Address - Street 1:3409 W 47TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-6339
Practice Address - Country:US
Practice Address - Phone:605-271-1081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND67291041C0700X
WY16641041C0700X
MT707311041C0700X
SD63801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6380OtherLICENSE
WY1664OtherLICENSE
ND6729OtherLICENSE
MT70731OtherLICENSE