Provider Demographics
NPI:1568209104
Name:NACHTIGALL, AUSTIN S
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:S
Last Name:NACHTIGALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6420
Mailing Address - Country:US
Mailing Address - Phone:605-371-6677
Mailing Address - Fax:
Practice Address - Street 1:6901 S LYNCREST PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2573
Practice Address - Country:US
Practice Address - Phone:605-368-1401
Practice Address - Fax:605-271-5542
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health