Individual
JAN M SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-MH, QMHP, LSWA
Contact information
Practice address
309 2ND AVE SE, WATERTOWN, SD 57201-3621
(605) 886-6321
(605) 886-6306
Mailing address
309 2ND AVE SE, WATERTOWN, SD 57201-3621
(605) 886-6321
(605) 886-6306
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-MH 2087
SD
101YP2500X
Professional Counselor
LPC-MH 2087
SD
104100000X
Social Worker
Primary
LSWA 2146
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11350
MIDLANDS CHOICE
—
05
—
154887500
—
MN
01
—
20202
SIOUX VALLEY HEALTH PLAN
SD
01
—
46045
AVERA HEALTH PLAN
SD
01
—
4997066
BLUE CROSS BLUE SHEILD
SD
05
—
6575620
—
SD
01
—
9173854
DAKOTACARE
SD
Enumeration date
01/17/2007
Last updated
09/11/2025
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