Healthcare Provider Details

I. General information

NPI: 1699280321
Provider Name (Legal Business Name): STACIA WAKEFIELD MS, LPC-MH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S SYCAMORE AVE STE 101
SIOUX FALLS SD
57110-4263
US

IV. Provider business mailing address

2000 S SYCAMORE AVE STE 101
SIOUX FALLS SD
57110-4263
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-0261
  • Fax: 605-271-0263
Mailing address:
  • Phone: 605-271-0261
  • Fax: 605-271-0263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: