Provider Demographics
NPI:1659809655
Name:FAUSTMAN, GEOFFREY ALAN (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:ALAN
Last Name:FAUSTMAN
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 65TH ST N
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-0420
Mailing Address - Country:US
Mailing Address - Phone:605-906-0309
Mailing Address - Fax:
Practice Address - Street 1:1000 E 65TH ST N
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-0420
Practice Address - Country:US
Practice Address - Phone:056-796-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD11525106H00000X
CA96882106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist