Active NPI
Holly Lynette Liston, LPC
- Marriage & Family Therapist
- Sioux Falls, SD
National Provider Identifier
1184933905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LPC-MH30594
- Practice address
- 407 S 2ND Ave # 1
Sioux Falls, SD 57104-6903 - Phone
- (712) 476-5245
- Fax
- (712) 476-9621
- NPI assigned
- Sep 28, 2010
- Last updated
- Apr 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 001329 | IA | |
| Marriage & Family Therapist | 106H00000X | LPC-MH30594 | SD | Primary |
Addresses
Primary practice location
407 S 2ND Ave # 1
Sioux Falls, SD 57104-6903
Mailing address
407 S 2ND Ave # 1
Sioux Falls, SD 57104-6903
Phone (605) 214-6855
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-MH30594 | SD | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yellow Brick Road Mental Health | Clinical | Past | Accepting new patients |
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.
-
dba Yellow Brick Road Counseling and Therapy
- Mental Health Counselor
- Sioux Falls, SD
- NPI 1275318966
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586390400000",
"number": "1184933905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 S 2ND AVE # 1",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571046903",
"telephone_number": "605-214-6855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S 2ND AVE # 1",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571046903",
"telephone_number": "712-476-5245",
"fax_number": "712-476-9621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISTON",
"first_name": "HOLLY",
"middle_name": "LYNETTE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-28",
"last_updated": "2020-04-09",
"certification_date": "2020-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "001329",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "SD",
"license": "LPC-MH30594",
"primary": true
}
],
"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 Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.