BETHESDA CHRISTIAN COUNSELING MIDWEST, INC. — NPI 1376522060 (Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) in SIOUX FALLS, SD)

CMS-1500 Box 24J / 33a • NPI

1376522060

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2084P0800X (CMS 26)

Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)

Box 32 Service Location & ZIP+4

400 S SYCAMORE AVE STE 105-3, SIOUX FALLS, SD, 57110-1255

✓ 9-Digit EDI 837 ZIP+4 (57110-1255)

Practice Phone & Referral Fax

(605) 334-3739

Fax: (605) 334-7752

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1376522060 (BETHESDA CHRISTIAN COUNSELING MIDWEST, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1376522060` (NPI-2 Organization / Facility)
Provider / Legal Name	BETHESDA CHRISTIAN COUNSELING MIDWEST, INC.
Plain-English Specialty	Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) NUCC Code: `2084P0800X` (Psychiatry & Neurology, Psychiatry)
Certifying / Licensing Body	American Board of Psychiatry and Neurology (ABPN)
Practice Location Address	400 S SYCAMORE AVE STE 105-3, SIOUX FALLS, SD, 57110-1255
Practice Telephone / Fax	Tel: (605) 334-3739 \| Fax: (605) 334-7752
Administrative Mailing Address	400 S SYCAMORE AVE, SIOUX FALLS, SD, 57110-1246
Enumeration & Last Sync	Enumerated: 2006-01-11 \| CMS Record Updated: 2021-08-12
Authorized Official	STACEY EETEN (Credentialing Coordinator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

400 S SYCAMORE AVE STE 105-3, SIOUX FALLS, SD, 57110-1255

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Plain-English Taxonomy & CMS Crosswalk (2084P0800X)

What Does Taxonomy Code 2084P0800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084P0800X translates to:
"Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 26 (Physician/Psychiatry) • CMS Code 86 (Physician/Neuropsychiatry)
Certifying / Accrediting Authority: American Board of Psychiatry and Neurology (ABPN)
Clinical Scope: Depression, generalized anxiety, panic attacks, insomnia, bipolar disorder, OCD, PTSD, or medical recovery from substance dependence.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BETHESDA CHRISTIAN COUNSELING MIDWEST, INC.)

Typical CPT / Diagnostic Procedures:

Comprehensive Psychiatric Diagnostic Evaluation (CPT 90792)
Psychopharmacological Management & Supportive Psychotherapy
Medication-Assisted Treatment (MAT) for Substance Use Disorders

Common Therapeutic Classes:

SSRIs & SNRIs (Sertraline, Escitalopram, Fluoxetine, Duloxetine)
Bupropion, Mirtazapine & Atypical Antipsychotics (Aripiprazole, Quetiapine)
Buprenorphine/Naloxone & Naltrexone (Addiction Recovery)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: IA \| License: `00291` \| Primary: Secondary
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: IA \| License: `001072` \| Primary: Secondary
`101YM0800X` — Counselor, Mental Health Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: IA \| License: `001696` \| Primary: Secondary
`101YP2500X` — Counselor, Professional Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor	State: SD \| License: `7288` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: MN \| License: `LP2939` \| Primary: Secondary
`103T00000X` — Psychologist Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist	State: SD \| License: `446` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: SD \| License: `673` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: SD \| License: `947` \| Primary: Secondary
`104100000X` — Social Worker Plain English: Licensed & Credentialed Social Worker	State: IA \| License: `06042` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: IA \| License: `085016` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: SD \| License: `086471` \| Primary: Secondary
`2084P0800X` — Psychiatry & Neurology, Psychiatry Plain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)	State: IA \| License: `27059` \| Primary: Secondary
`261QM0801X` — Clinic/Center, Mental Health (Including Community Mental Health Center) Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`2084P0800X` — Psychiatry & Neurology, Psychiatry Plain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)	State: SD \| License: `2080` \| Primary: Yes (Primary)

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BETHESDA CHRISTIAN COUNSELING MIDWEST, INC. (NPI #1376522060)