JESSICA MARIE PETERSON (NPI# 1194292805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194292805 |
| Entity Type | Individual |
| Full Name | JESSICA MARIE PETERSON |
| Other Name | JESSICA MARIE PETERSON |
| Practice Address |
4 Garfield Ave Sagamore MA 02561-0718 |
| Mailing Address |
Po Box 718 Sagamore MA 02561-0718 |
| Practice Telephone | 7749942928 |
| Mailing Telephone | 7749942928 |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2020-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720581952 | Jessica Ann Peterson | Chiropractor | 1305 E College Dr Ste B, Marshall, MN 56258-2073 | 2018-03-14 |
| 1801399431 | Jessica Lynn Peterson | Psychologist | Chdd 1701 Ne Columbia Rd Seattle Wa 98195, Seattle, WA 98195-0001 | 2018-03-09 |
| 1669901260 | Jessica Peterson | Social Worker | 1200 W Ironwood Dr Ste 100, Coeur D Alene, ID 83814-2660 | 2017-06-07 |
| 1609265826 | Jessica Peterson | Licensed Practical Nurse | 389 W 29th Ave, Eugene, OR 97405-2726 | 2015-01-12 |
| 1306266903 | Jessica Kristen Peterson | Radiology | 250 E Superior St Ste 4-2304, Chicago, IL 60611-2914 | 2014-04-22 |
| 1083043632 | Jessica Peterson | Social Worker | 5228 Cypress Ct, Shelbyville, KY 40065-7764 | 2013-11-04 |
| 1265778476 | Jessica Peterson | Nutritionist | 966 12th St Se Ste 130, Salem, OR 97302-2860 | 2012-12-14 |
| 1780829606 | Jessica Lynn Peterson | Chiropractor | 3476 3rd St Ne, Minneapolis, MN 55418-1111 | 2008-12-05 |
| 1497966238 | Jessica Ann Peterson | Social Worker | 1585 Thomas Center Dr, Ste 104, Eagan, MN 55122-3039 | 2007-05-24 |
| 1073531141 | Jessica Lynn Peterson | Chiropractor | 901 Kentucky St Ste 102, Lawrence, KS 66044-2853 | 2006-07-17 |
| Street Address |
4 GARFIELD AVE |
| City | SAGAMORE |
| State | MA |
| Zip Code | 02561-0718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669477402 | Andrea M Lamb | Social Worker | 109 Adams Street, Sagamore, MA 02561-0109 | 2005-06-17 |
| 1881844223 | Matthew Ryan Reid | Social Worker | 109 Adams Street, Sagamore, MA 02561-0109 | 2008-09-23 |
| 1164493979 | Gregory Taylor Bodrie | Optometrist | 66 Pleasant St., Sagamore, MA 02561-0532 | 2006-01-30 |
| 1992973986 | Gregory T Bodrie Od | Durable Medical Equipment & Medical Supplies | 66 Pleasant St., Sagamore, MA 02561-0532 | 2008-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164493979 | Gregory Taylor Bodrie | Optometrist | 66 Pleasant St., Sagamore, MA 02561-0532 | 2006-01-30 |
| 1669477402 | Andrea M Lamb | Social Worker | 109 Adams Street, Sagamore, MA 02561-0109 | 2005-06-17 |
| 1881844223 | Matthew Ryan Reid | Social Worker | 109 Adams Street, Sagamore, MA 02561-0109 | 2008-09-23 |
| 1992973986 | Gregory T Bodrie Od | Durable Medical Equipment & Medical Supplies | 66 Pleasant St., Sagamore, MA 02561-0532 | 2008-02-13 |
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596703 | Courtney Rose Bieda | Counselor | 1340 Washington St Apt 3, Weymouth, MA 02189-2360 | 2020-10-21 |
| 1023617339 | Meghan Earle | Counselor | 1354 Hancock St Ste 214, Quincy, MA 02169-5109 | 2020-10-19 |
| 1104425420 | Mindful Path Therapy LLC | Counselor | 163 Highland Ave # 1057, Needham, MA 02494-3025 | 2020-10-19 |
| 1184222531 | Antoinett Gomes | Counselor | 11 Battles St Apt 3, Brockton, MA 02301-2236 | 2020-10-16 |
| 1710585252 | Andrada Mihaila | Counselor | 120 Maple St Ste 301, Springfield, MA 01103-2216 | 2020-10-16 |
| 1780282335 | Susan Warren | Counselor | Martha's Vineyard Community Services, 111 Edgartown Rd, Oak Bluffs, MA 02557 | 2020-10-15 |
| 1831797646 | Paula Arrigg | Counselor | 175 Dwight Road, Longmeadow, MA 01106 | 2020-10-14 |
| 1790383693 | Bowlight Partners LLC | Counselor | 32 Edgewood Rd, Lexington, MA 02420-3500 | 2020-10-13 |
| 1316545510 | Leonard Paul Dagesse | Counselor | 51 Gladstone St, Brockton, MA 02302-3338 | 2020-10-12 |
| 1659979847 | Melina Canter | Counselor | 581 Pleasant St Apt 2r, Holyoke, MA 01040-2368 | 2020-10-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.