Provider Demographics
NPI:1588785943
Name:MAASS, RONDA J (MA, LPC-MH,NCC, QMHP)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:J
Last Name:MAASS
Suffix:
Gender:F
Credentials:MA, LPC-MH,NCC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5201 S WESTERN AVE
Mailing Address - Street 2:STE. 104
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5040
Mailing Address - Country:US
Mailing Address - Phone:605-275-0075
Mailing Address - Fax:605-231-4252
Practice Address - Street 1:5201 S WESTERN AVE
Practice Address - Street 2:STE. 104
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5040
Practice Address - Country:US
Practice Address - Phone:605-275-0075
Practice Address - Fax:605-231-4252
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD20367OtherSIOUX VALLEY HEALTH PLAN
SD990241029716OtherPREFERED ONE
SD9211183OtherDAKOTACARE