MR. TRENTON JON PETERSON (NPI# 1205921657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205921657 |
| Entity Type | Individual |
| Full Name | MR. TRENTON JON PETERSON |
| Credential | MA, LMFT, LADC |
| Practice Address |
630 E Main St Anoka MN 55303 |
| Mailing Address |
630 E Main St Anoka MN 55303-2527 |
| Practice Telephone | 7637121903 |
| Practice Fax Number | 7637121917 |
| Mailing Telephone | 7637121903 |
| Mailing Fax Number | 7637121917 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-07-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 1117 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 687622600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 403 Jackson St., Suite 308, Anoka, MN 55303 | 7637121903 | 7637121917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101867 | Trenton Lee Peterson | Physician Assistant | 21651 Trail Blazer Ln, Escondido, CA 92029-4845 | 2020-07-06 |
| Street Address |
630 E MAIN ST |
| City | ANOKA |
| State | MN |
| Zip Code | 55303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740814755 | Kristen N Paradise | Counselor | 630 E Main St, Anoka, MN 55303-2527 | 2020-02-28 |
| 1144704396 | Sarah Elisabeth Haller | Marriage & Family Therapist | 630 E Main St, Anoka, MN 55303-2527 | 2018-09-23 |
| 1659872521 | Ashley Elizabeth Dimas | Counselor | 630 E Main St, Anoka, MN 55303-2527 | 2018-02-26 |
| 1184002784 | Optiovillage, Inc | Community/Behavioral Health | 630 E Main St, Anoka, MN 55303-2527 | 2015-05-14 |
| 1124428222 | Jill Maria Scott | Nurse Practitioner | 630 E Main St, Anoka, MN 55303 | 2014-08-26 |
| 1861835829 | Lisa Mortie Reynoso | Counselor | 630 E Main St, Anoka, MN 55303-2527 | 2013-04-09 |
| 1841493608 | Genuine Therapy Center | Community/Behavioral Health | 630 E Main St, Anoka, MN 55303 | 2007-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962009548 | Emily Ongaga | Nurse Practitioner | 43 10 Parkview Circle, Anoka, MN 55303 | 2020-10-06 |
| 1568083111 | Suite Living Senior Care of Ramsey | Assisted Living Facility | 7007 139th Lane Nw, Ramsey, MN 55303 | 2020-05-05 |
| 1154942258 | Naomi Nystrom | Clinical Neuropsychologist | Psychology-building A, 3301 7th Ave. N, Anoka, MN 55303 | 2020-04-29 |
| 1104452135 | Vnv Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 15200 Helium Street Nw, Ramsey, MN 55303 | 2020-03-22 |
| 1043851165 | Mary Rahn | Technician | 20650 Poppy St. Nw, Oak Grove, MN 55303 | 2019-09-30 |
| 1417509100 | Deka Ahmed Abdulle | Advanced Practice Midwife | 601 Jacob Lane, Mail Stop 39300a, Anoka, MN 55303 | 2019-07-12 |
| 1952818981 | Golden Hearts Home Care Services | Home Health | 609 Parkview Ct, Anoka, MN 55303 | 2017-12-29 |
| 1144740143 | Margret Kallstrom | Occupational Therapist | 929 Adams St., Anoka, MN 55303 | 2017-06-21 |
| 1376095471 | Sabra Ramsey Trs, LLC | Assisted Living Facility | 14401 Nowthen Blvd Nw, Ramsey, MN 55303 | 2016-10-25 |
| 1356794135 | Katlyn Marie Bass | Chiropractor | 1902 5th Ave S Suite 5, Anoka, MN 55303 | 2016-07-18 |
| Find all providers in zip 55303 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194116590 | Elisabeth Ann Gliddon | Marriage & Family Therapist | 856 Birch St, Anoka, MN 55303-2852 | 2015-02-07 |
| 1891199618 | Amber Rose Fuller | Marriage & Family Therapist | 2006 1st Ave Ste 201, Anoka, MN 55303-2255 | 2014-10-22 |
| 1508015363 | Dana Lynn Nagel | Marriage & Family Therapist | 20955 Cobalt St Nw, Anoka, MN 55303-9674 | 2008-09-16 |
| 1558429506 | Melissa Diane Savage | Marriage & Family Therapist | 1833 3rd Ave, Anoka, MN 55303-2424 | 2006-12-04 |
| 1366521007 | Joan Antonia Newbolt | Marriage & Family Therapist | 2006 1st Ave Ste B10, Anoka, MN 55303-2255 | 2006-11-03 |
| 1003874009 | Richard Wade Chamberlin | Marriage & Family Therapist | 12 Bridge Sq Ste 207, Anoka, MN 55303 | 2006-05-02 |
| 1730744756 | Rebecca Mitchell | Marriage & Family Therapist | 1833 3rd Ave, Anoka, MN 55303-2424 | 2019-05-06 |
| 1144704396 | Sarah Elisabeth Haller | Marriage & Family Therapist | 630 E Main St, Anoka, MN 55303-2527 | 2018-09-23 |
| 1992248231 | Gretchen Phung | Marriage & Family Therapist | 2829 Verndale Ave, Anoka, MN 55303-1620 | 2016-11-18 |
| 1306204078 | Jessica Hase | Marriage & Family Therapist | 2829 Verndale Ave, Anoka, MN 55303-1620 | 2016-02-09 |
| Find all providers in ANOKA | ||||
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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.