Tokata Etunwan Wakanyeza Owicakiyapi

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TOKATA ETUNWAN WAKANYEZA OWICAKIYAPI

Practice address

28572 Bia 1
Rosebud, SD 57570

Phone

(605) 515-3511

NPI assigned

Dec 5, 2025

Last updated

Dec 5, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charisse Nichelle Bordeaux, MS, LPC, NCC, QMHPNPI 1043760234

Title

Director of Counselor Education

Phone

(605) 515-3511

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charisse Nichelle Bordeaux

  • Mental Health Counselor
  • Rosebud, SD
  • NPI 1043760234
  NPD Authorized official

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

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1801759956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 253",
            "city": "ROSEBUD",
            "state": "SD",
            "postal_code": "575700253",
            "telephone_number": "605-515-3511",
            "fax_number": "605-515-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28572 BIA 1",
            "city": "ROSEBUD",
            "state": "SD",
            "postal_code": "57570",
            "telephone_number": "605-515-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOKATA ETUNWAN WAKANYEZA OWICAKIYAPI",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-05",
        "last_updated": "2025-12-05",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "BORDEAUX",
        "authorized_official_first_name": "CHARISSE",
        "authorized_official_middle_name": "NICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF COUNSELOR EDUCATION",
        "authorized_official_telephone_number": "605-515-3511",
        "authorized_official_credential": "MS, LPC, NCC, QMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Jo Sully, REGISTERED NURSE
• Mary Elizabeth Tamayo, REGISTERED NURSE
• Maria Teachout
• Ruth M Thomas, PA-C
• Anna Marie Thompson, RN, DPHN
• Total Renal Care Inc (Rosebud Dialysis)
• Tanya Jolette Twobulls, REGISTERED NURSE
• Michelle Vandermay, REGISTERED NURSE
• Ardean G Vernon, REGISTERD NURSE
• Dorothy S Vershure, REGISTERED PHARMACIS

• Mental Health Counselor in Rosebud, SD
• Providers in Rosebud, SD by specialty
• Mental Health Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.