Provider Demographics
NPI:1053096628
Name:LOVE OF PLAY THERAPY, LLC
Entity type:Organization
Organization Name:LOVE OF PLAY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:CSW-PIP
Authorized Official - Phone:605-202-5870
Mailing Address - Street 1:5423 W 57TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2097
Mailing Address - Country:US
Mailing Address - Phone:605-366-9577
Mailing Address - Fax:
Practice Address - Street 1:1601 E 69TH ST STE 307
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8322
Practice Address - Country:US
Practice Address - Phone:605-202-5870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty