Provider Demographics
NPI:1992819122
Name:SHROYER, LYN MARIE (EDD)
Entity type:Individual
Prefix:DR
First Name:LYN
Middle Name:MARIE
Last Name:SHROYER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 S KIWANIS AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-373-9066
Mailing Address - Fax:605-373-9145
Practice Address - Street 1:3710 S KIWANIS AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-373-9066
Practice Address - Fax:605-373-9145
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD341101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
7880OtherMIDLANDS CHOICE
HP29927OtherHEALTH PARTNERS
0201057OtherUNITED HEALTH CARE
106124OtherCHOICE PLUS
SD6551012Medicaid
2032OtherAVERA HEALTH PLANS
86725OtherHEALTH PARTNERS
0040633OtherBLUE CROSS BLUE SHIELD
22415OtherSIOUX VALLEY HEALTH PLAN
2032OtherAVERA HEALTH PLANS