Provider Demographics
NPI:1871621292
Name:DEKRAAI, JEFFREY E (MS, LPC-MH)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:E
Last Name:DEKRAAI
Suffix:
Gender:M
Credentials:MS, LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-1540
Mailing Address - Country:US
Mailing Address - Phone:605-720-8090
Mailing Address - Fax:605-720-8090
Practice Address - Street 1:1238 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-1540
Practice Address - Country:US
Practice Address - Phone:605-720-8090
Practice Address - Fax:605-720-8090
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health