Provider Demographics
NPI:1134735764
Name:CARLSON, FAITH CHARIS (LPC-MH)
Entity type:Individual
Prefix:MS
First Name:FAITH
Middle Name:CHARIS
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57101-0645
Mailing Address - Country:US
Mailing Address - Phone:605-595-3653
Mailing Address - Fax:
Practice Address - Street 1:5000 SOUTH MINNESOTA AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2700
Practice Address - Country:US
Practice Address - Phone:605-951-9100
Practice Address - Fax:605-951-9102
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPMC3061101YM0800X
SDLPC20570101YM0800X
SDLPC-MH30636101YM0800X
MN2537101YM0800X
IA114460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health