Provider Demographics
NPI:1720824774
Name:VAN SLOTEN, MEGAN BROOKE (MSW, CSW-PIP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BROOKE
Last Name:VAN SLOTEN
Suffix:
Gender:
Credentials:MSW, CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 S KATIE AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4940
Mailing Address - Country:US
Mailing Address - Phone:712-230-0298
Mailing Address - Fax:
Practice Address - Street 1:2501 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1305
Practice Address - Country:US
Practice Address - Phone:605-336-3230
Practice Address - Fax:612-725-1266
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6309104100000X
SD67801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker