MS. STACEY LYNN PETERSON (NPI# 1538326244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538326244 |
| Entity Type | Individual |
| Full Name | MS. STACEY LYNN PETERSON |
| Credential | MS |
| Practice Address |
10909 Memorial Hwy Tampa FL 33615-2511 |
| Mailing Address |
79 W Alexandrine St Detroit MI 48201-2015 |
| Practice Telephone | 8138554435 |
| Practice Fax Number | 8138641325 |
| Mailing Telephone | 3138315535 |
| Mailing Fax Number | 3138312608 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2017-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301010935 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023262896 | Stacey Debra Oberst Peterson | Dietitian, Registered | 500 Sw 39th St, Suite 150, Renton, WA 98057-4915 | 2008-11-06 |
| Street Address |
10909 MEMORIAL HWY |
| City | TAMPA |
| State | FL |
| Zip Code | 33615-2511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003896606 | The Children's Home, Inc. | Custodial Care Facility | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2006-01-19 |
| 1003430158 | Jordyn Vanvakas | Behavior Technician | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2020-06-04 |
| 1457997207 | Gabrielle Chanell Balancier | Counselor | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2019-11-26 |
| 1568830057 | Johnny Zambito | Counselor | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2015-09-14 |
| 1154725463 | Hannah Buck | Behavioral Analyst | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2014-10-15 |
| 1841610409 | Margaret Clark | Social Worker | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2014-04-22 |
| 1952656126 | Katheryne Maria Holtan | Social Worker | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2012-07-13 |
| 1205196490 | Amanda Hanson | Counselor | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2012-05-21 |
| 1427365188 | Rebecca M Smith | Counselor | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2010-09-01 |
| 1467766105 | Andrea Nicole Garcia | Social Worker | 10909 Memorial Hwy, Tampa, FL 33615-2511 | 2010-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083125132 | The Ida House Assisted Living LLC | Assisted Living Facility | 6014 Rosewood Dr, Tampa, FL 33615 | 2017-10-17 |
| 1235671785 | Magnet Home Health Care Services, LLC | Home Health | 5700 Memorial Highway Suite G X H 102, Tampa, FL 33615 | 2016-11-15 |
| 1891247532 | Martin Esuzor | Nurse Practitioner | 7918 Hillsborough Avenue, Tampa, FL 33615 | 2016-10-28 |
| 1902263007 | Marie E. Simeon | Nursing Facility/Intermediate Care Facility | 8206 Pennywell Place, Tampa, FL 33615 | 2016-01-20 |
| 1598183659 | Mustafa Mohammad | Dermatology | 6001 Memorial Highway, Tampa, FL 33615 | 2014-04-04 |
| 1710327101 | Kelly A Alvarez | Case Manager/Care Coordinator | 7007 Cobblewood Ct, Tampa, FL 33615 | 2013-06-28 |
| 1336497080 | Serenity Home of Tampa Alf LLC | Assisted Living Facility | 6013 Cresthill Drive, Tampa, FL 33615 | 2012-08-28 |
| 1063777563 | Jaime Alexander Pacheco | Chiropractor | 6301 Memorial Hwy Suit 304, Tampa, FL 33615 | 2012-07-10 |
| 1558656678 | Scripts Direct, LLC | Pharmacy | 8313 W. Hillsborough Ave., # 260, Tampa, FL 33615 | 2011-06-16 |
| 1508178245 | The Spring of Tampa Bay | Counselor | 2810 N. 35 St, Tampa, FL 33615 | 2010-07-10 |
| Find all providers in zip 33615 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744327 | Lisa Stewart | Psychologist | 13000 Bruce B Downs Blvd Bldg 68, Tampa, FL 33612-4745 | 2020-09-15 |
| 1205488012 | Kimberly Hubinger | Psychologist | 3825 Henderson Blvd Ste 505c, Tampa, FL 33629-5037 | 2019-07-11 |
| 1528537362 | Bethan Anne Roberts | Psychologist | 13000 Bruce B Downs Blvd Rm 163, Tampa, FL 33612-4745 | 2018-11-23 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1962979583 | Rosana Marzullo-dove | Psychologist | 912 W Platt St Ste 101, Tampa, FL 33606-2108 | 2018-11-01 |
| 1740764158 | Fabian Alexandro Consbruck | Psychologist | 5425 Beaumont Center Blvd Ste 918, Tampa, FL 33634-5214 | 2018-09-20 |
| 1154810802 | Lashley Marks | Psychologist | 4202 E Fowler Ave Stop Svc2124, Tampa, FL 33620-6970 | 2018-05-08 |
| 1922595305 | Carmen Ana Gonzalez-magaz | Psychologist | 836 S Davis Blvd, Tampa, FL 33606-4025 | 2018-04-20 |
| 1811494982 | Adam Zimmer | Psychologist | 4202 E Fowler Ave Shs 100, Tampa, FL 33620-6750 | 2018-04-06 |
| 1326553389 | My Psychology Place Inc. | Psychologist | 6601 Memorial Hwy Ste 310, Tampa, FL 33615-4501 | 2017-12-12 |
| Find all providers in TAMPA | ||||
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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.