Alyssa Raelynn Petersen, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCMH-30589 Issued in SD

Practice address

4000 N Brendan LN
Sioux Falls, SD 57107-1286

Phone

(605) 332-2883

NPI assigned

May 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicolle Olson

  • Mental Health Counselor
  • Sioux Falls, SD
  • NPI 1982286266

  SD

  Medicare reassignment
• Melanie Jane Van Tol

  • Clinical Social Worker
  • Sioux Falls, SD
  • NPI 1811846447

  SD

  Medicare reassignment

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

• Sanford Clinic

  • Psychologist
  • Sioux Falls, SD
  • NPI 1396764254

  SD

  Medicare reassignment NPD
• Sanford Medical Center

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1093090342

  SD

  Medicare reassignment NPD
• Sanford Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1013948439
  NPD
• Sanford Medical Center

  • Rural Health Clinic/Center
  • Lake Norden, SD
  • NPI 1417927559
  NPD
• Sanford Clinic

  • Diagnostic Radiology Physician
  • Fargo, ND
  • NPI 1306641345
  NPD

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1336714039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 N BRENDAN LN",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571071286",
            "telephone_number": "605-332-2883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 S Phillips Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571056864",
            "country_code": "US",
            "telephone_number": "605-403-3890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ALYSSA",
        "middle_name": "RAELYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPCMH-30589",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC-20530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alyssa@alyssadomelcounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3500 S Phillips Ave Ste 118",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571056864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles Peters
• Jane M Peters, M.D.
• Jena Lee Peters
• Patricia Peters, M.D.
• Shannon M Peters, MD
• Andria Jo Petersen, NP-C
• Bonnie J Petersen, CNP
• Kara Linda Petersen, M.D.
• Melanie Petersen
• Treva L Petersen, LPN

• All providers in Sioux Falls, SD
• Professional Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.