Provider Demographics
NPI:1588391312
Name:KONOLD, CURSTIE
Entity type:Individual
Prefix:
First Name:CURSTIE
Middle Name:
Last Name:KONOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2377
Mailing Address - Country:US
Mailing Address - Phone:605-692-2790
Mailing Address - Fax:
Practice Address - Street 1:1024 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2205
Practice Address - Country:US
Practice Address - Phone:605-692-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical