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WAKIYAN PETA LAC
NPI 1043090822
Counselor - Addiction (Substance Use Disorder) in Eagle Butte, SD

Active since September 29, 2023
24276 166TH ST, EAGLE BUTTE, SD 57625(605) 964-0722(605) 964-8905 Get Directions Write a Review

NPPES record last updated: September 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wakiyan Peta Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAKIYAN PETA LAC (NPI 1043090822) is an individual addiction (substance use disorder) provider in Eagle Butte, South Dakota, licensed in South Dakota (7051316) and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1043090822
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameWAKIYAN PETACredential: LAC
Location Address24276 166TH STEagle Butte, SD 57625-8141
Mailing AddressPo Box 83Lantry, SD 57636-0083 · (605) 200-5052
Phone(605) 964-0722
Fax(605) 964-8905
Sole ProprietorYes
Enumeration DateSeptember 29, 2023
NPPES CertifiedSeptember 29, 2023
✔ NPI 1043090822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in SD · 7051316
24276 166TH ST, Eagle Butte, SD 57625
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUZIE M CHHOUK PHARMD
Pharmacist
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-1520
MS. ANGEL LEE WILSON-CROWE ARNP
Nurse Practitioner (Family)
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0675
SUSAN SEITZ
Registered Nurse
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-7724
DR. LATILIA DEANNE MACK PHARM.D.
Pharmacist
24276 166TH ST, AIRPORT RD
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0650
CRST COMMUNITY HEALTH REPRESENTATIVES (CHR) PROGRAM
Non-emergency Medical Transport (VAN)
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0728
DR. MONTE LOREN KRANZ D.D.S.
Dentist
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0736
CHEYENNE RIVER SIOUX TRIBE FIELD HEALTH CLINIC
Clinic/Center (Primary Care)
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0785
CHEYENNE RIVER SIOUX TRIBE
Durable Medical Equipment & Medical Supplies
24276 166TH ST
EAGLE BUTTE, SD 57625
Dewey County (605) 964-0772

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wakiyan Peta's NPI number?

The NPI number for Wakiyan Peta is 1043090822. It was assigned to this individual provider in the NPPES registry on September 29, 2023.

Where is Wakiyan Peta located?

Wakiyan Peta practices at 24276 166th St, Eagle Butte, SD 57625. The listed phone number is (605) 964-0722.

What is Wakiyan Peta's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Wakiyan Peta was last updated on September 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.