Individual
BEVERLY J GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
4400 W 69TH ST, STE 1500, SIOUX FALLS, SD 57108-8170
(605) 322-5700
(605) 322-5704
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
195
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040485
BLUE CROSS
SD
01
—
040121002
PRIMEWEST
MN
01
—
10635
MIDLANDS CHOICE
SD
05
—
12200
—
ND
01
—
122288
UCARE
MN
01
—
141M3GU
CC SYSTEMS/ BLUE PLUS
MN
01
—
28142
SANFORD HEALTH PLAN
SD
05
—
3989442
—
IA
01
—
412991028090
PREFERRED ONE
SD
05
—
46022474352
—
NE
01
—
57108C025
WPS TRICARE
SD
05
—
581816800
—
MN
01
—
596332
ARAZ/ AMERICA'S PPO
SD
05
—
6550806
—
SD
01
—
680015878
RR MEDICARE
SD
01
—
HP24855
HEALTPARTNERS
SD
01
—
P195
DAKOTACARE
SD
Enumeration date
02/07/2006
Last updated
10/11/2018
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