Provider Demographics
NPI:1124734256
Name:WIGGERS COUNSELING LLC
Entity type:Organization
Organization Name:WIGGERS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:WIGGERS
Authorized Official - Suffix:
Authorized Official - Credentials:CSW-PIP, QMHP
Authorized Official - Phone:616-820-9595
Mailing Address - Street 1:2000 S SYCAMORE AVE # 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4263
Mailing Address - Country:US
Mailing Address - Phone:605-271-0261
Mailing Address - Fax:
Practice Address - Street 1:2000 S SYCAMORE AVE # 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4263
Practice Address - Country:US
Practice Address - Phone:605-275-2280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty