Provider Demographics
NPI:1538734264
Name:ALYSSA PETERSEN MENTAL HEALTH COUNSELING, LLC
Entity type:Organization
Organization Name:ALYSSA PETERSEN MENTAL HEALTH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC-MH, LAC,
Authorized Official - Phone:605-321-9762
Mailing Address - Street 1:3500 S PHILLIPS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6864
Mailing Address - Country:US
Mailing Address - Phone:605-215-5081
Mailing Address - Fax:605-231-5460
Practice Address - Street 1:3500 S PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6839
Practice Address - Country:US
Practice Address - Phone:605-403-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty