Individual provider Active NPI

Faith Charis Carlson, LPC-MH

  • Mental Health Counselor
  • Sioux Falls, SD
National Provider Identifier
1134735764
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
TPMC3061 Issued in FL
Practice address
5000 South Minnesota Avenue
Suite 100
Sioux Falls, SD 57108-2700
Phone
(605) 951-9100
Fax
(605) 951-9102
NPI assigned
Sep 18, 2020
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X TPMC3061 FL Primary
Mental Health Counselor 101YM0800X LPC20570 SD
Mental Health Counselor 101YM0800X LPC-MH30636 SD
Mental Health Counselor 101YM0800X 2537 MN
Mental Health Counselor 101YM0800X 114460 IA

Addresses

Primary practice location

5000 South Minnesota Avenue
Suite 100
Sioux Falls, SD 57108-2700

Mailing address

PO Box 645
Sioux Falls, SD 57101-0645
Phone (605) 595-3653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TPMC3061FLMDMental Health Counselor
114460IAMDMental Health Counselor
LPC-MH30636SDMDMental Health Counselor
LPC20570SDMDMental Health Counselor
2537MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Victus Counseling, LLC Mental Health CurrentSince Jul 16, 2023 Accepting new patients

Locations

5000 S Minnesota Ave
Ste 100
Sioux Falls, SD 57108
Phone (605) 371-6899

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1134735764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571010645",
            "telephone_number": "605-595-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SOUTH MINNESOTA AVENUE",
            "address_2": "SUITE 100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082700",
            "telephone_number": "605-951-9100",
            "fax_number": "605-951-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "FAITH",
        "middle_name": "CHARIS",
        "name_prefix": "Ms.",
        "credential": "LPC-MH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2024-01-24",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "TPMC3061",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC20570",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC-MH30636",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2537",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "114460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.