SUSAN PETERSON (NPI# 1255797890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255797890 |
| Entity Type | Individual |
| Full Name | SUSAN PETERSON |
| Credential | CMHC |
| Practice Address |
4501 N University Ave Provo UT 84604-5504 |
| Practice Telephone | 8012272057 |
| Practice Fax Number | 8012272095 |
| Mailing Telephone | 8012272057 |
| Mailing Fax Number | 8012272095 |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
5476575-6004 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801378021 | Susan Nell Peterson | Speech-Language Pathologist | 1045 18th St Sw, Huron, SD 57350-3464 | 2018-09-04 |
| 1366709750 | Susan Harper Peterson | Counselor | 1560 Olympia Cir, #103, Castle Rock, CO 80104-5464 | 2012-04-23 |
| 1972819712 | Susan Karen Peterson | Dietitian, Registered | 3965 Crystal Lake Trl, Faribault, MN 55021-7974 | 2010-08-30 |
| 1255475166 | Susan Peterson | Psychologist | 924 Old Harmony Rd, Suite 201, Newark, DE 19713-4184 | 2007-02-16 |
| 1922178839 | Susan F Peterson | Respiratory Therapist, Registered | 61 Broad Reach, T114-b, North Weymouth, MA 02191-2229 | 2006-11-08 |
| 1104908540 | Susan Peterson | Physical Therapist | 134 Drury Dr, La Plata, MD 20646-4241 | 2006-10-19 |
| 1013014349 | Susan K. Peterson | Social Worker | 1513 25th Ave, Seattle, WA 98122-3017 | 2006-09-20 |
| 1497860480 | Susan A Peterson | Occupational Therapist | 13253 E Playfield Dr, Crestwood, IL 60445 | 2006-08-20 |
| 1003854217 | Susan Mary Peterson | Registered Nurse | 20600 Milton Ct, Brookfield, WI 53045-4020 | 2006-06-02 |
| 1396738803 | Susan Margaret Peterson | Nurse Practitioner | J457 Kentucky Clinic, 740 South Limestone St, Lexington, KY 40536-0284 | 2005-08-30 |
| Street Address |
4501 N UNIVERSITY AVE |
| City | PROVO |
| State | UT |
| Zip Code | 84604-5504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609843523 | Uhs Provo Canyon Inc | Psychiatric Residential Treatment Facility | 4501 N University Ave, Provo, UT 84604-5504 | 2006-03-01 |
| 1093334070 | Steve Murdock | Counselor | 4501 N University Ave, Provo, UT 84604-5504 | 2020-04-10 |
| 1407482482 | Laraine Murdock | Social Worker | 4501 N University Ave, Provo, UT 84604-5504 | 2020-03-21 |
| 1881237352 | Lauren Owens | Registered Nurse | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-28 |
| 1659914356 | Tack D Macgregor | Registered Nurse | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-25 |
| 1457994162 | Timothy W Bartell | Registered Nurse | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-25 |
| 1346883915 | Jone Lokahi D.t.l. Vuikadavu | Counselor | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-25 |
| 1255974085 | Universal Health Systems | Community Based Residential Treatment Facility, Mental Illness | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-24 |
| 1619510575 | Shawn Kraling | Licensed Practical Nurse | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-23 |
| 1851934707 | Vicky Suruky | Registered Nurse | 4501 N University Ave, Provo, UT 84604-5504 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245792167 | Adrienne Lowden Dejager | Counselor | 314 S 1350 E, Provo, UT 84606-5318 | 2019-04-01 |
| 1699255315 | Michele Mcconkie Erekson | Counselor | 2545 N Canyon Rd Ste 112, Provo, UT 84604-5972 | 2018-08-21 |
| 1861980385 | Cory Bushman | Counselor | 455 N University Ave Ste 210, Provo, UT 84601-2868 | 2018-04-30 |
| 1013425594 | Tamara S Hill | Counselor | 3325 N University Ave Ste 275, Provo, UT 84604-7415 | 2018-01-18 |
| 1992150478 | Tristin Roney | Counselor | 1942 N 3100 W, Provo, UT 84601-5941 | 2016-05-03 |
| 1659760411 | Affinity Guidance Services, Inc | Counselor | 1971 N State St, Provo, UT 84604-1012 | 2015-01-16 |
| 1326460445 | Daniel Solen | Counselor | 2230 N University Pkwy Ste 11d, Provo, UT 84604-1583 | 2014-01-08 |
| 1235550526 | Richard James Bryan | Counselor | 567 N 2620 W, Provo, UT 84601-1187 | 2014-01-03 |
| 1508287947 | Ann Weight | Counselor | 4455 Wimbledon Dr, Provo, UT 84604-5394 | 2014-01-03 |
| 1508118456 | Linda Marie Taylor | Counselor | 719 N 1890 W Ste 38b, Provo, UT 84601-1333 | 2012-10-02 |
| Find all providers in PROVO | ||||
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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.