DR. FREDERICK L PETERSON JR.


Address: 627 S Edwin C Moses Blvd, Suite K 5th Floor, Dayton, OH 45408-1461
Phone: 9374241000

DR. FREDERICK L PETERSON JR. (NPI# 1790708725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790708725
Entity Type Individual
Full Name DR. FREDERICK L PETERSON JR.
Credential PSY.D
Practice Address 627 S Edwin C Moses Blvd
Suite K 5th Floor
Dayton
OH 45408-1461
Mailing Address 1311 E High St
Springfield
OH 45505-1125
Practice Telephone 9374241000
Enumeration Date 2006-07-25
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 3738 OH Behavioral Health & Social Service Providers

Other Providers FREDERICK PETERSON

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1407014228 Frederick J Peterson Nurse Anesthetist, Certified Registered 51 N 39th St, Philadelphia, PA 19104-2640 2008-05-29
1215913165 Frederick Peterson Family Medicine 6100 Minton Rd Nw, Ste104, Palm Bay, FL 32907-1975 2005-12-21

Office Location

Street Address 627 S EDWIN C MOSES BLVD
SUITE K 5TH FLOOR
City DAYTON
State OH
Zip Code 45408-1461

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114919065 Dvl Vascular Lab Inc Radiology 627 S Edwin C Moses Blvd, Suite 3h, Dayton, OH 45417-3461 2005-08-17
1447813720 Andy Chung Hur Student in an Organized Health Care Education/Training Program 627 S Edwin C Moses Blvd, Dayton, OH 45417-3461 2019-04-22
1932669033 Brandon Saia Student in an Organized Health Care Education/Training Program 627 S Edwin C Moses Blvd, East Medical Plaza, Dayton, OH 45417 2019-03-23
1952832446 Jonathan Hester Psychiatry & Neurology 627 S Edwin C Moses Blvd, East Medical Plaza, 1st Floor, Dayton, OH 45417-3461 2017-03-25
1275081564 Jonathan Omane Physician Assistant 627 S Edwin C Moses Blvd, Dayton, OH 45417-3461 2016-09-14
1134574098 Randy Smith Student in an Organized Health Care Education/Training Program 627 S Edwin C Moses Blvd, Dayton, OH 45417-3461 2016-04-28
1982099941 David Provaznik Jr. Psychiatry & Neurology 627 S Edwin C Moses Blvd, East Medical Plaza 1st Floor, Dayton, OH 45417-3461 2015-04-06
1700206992 Logan Parrott Student in an Organized Health Care Education/Training Program 627 S Edwin C Moses Blvd, Dayton, OH 45417-3461 2014-04-26
1639483217 Matthew R Newton Psychiatry & Neurology 627 S Edwin C Moses Blvd, Department of Psychiatry, Dayton, OH 45417-3461 2010-08-05
1295059129 Dayton Cardiac Surgery Thoracic Surgery (Cardiothoracic Vascular Surgery) 627 S Edwin C Moses Blvd, Suite Emp 5j, Dayton, OH 45417-3461 2010-03-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649441817 Western Ohio Psychiatric Institute, LLC Psychiatric Unit 601 Edwin Moses Boulevard, Dayton, OH 45408 2008-03-17
1730363813 Susan C Mumford Social Worker 627 S. Edwin C. Moses Blvd, Suite 100, Dayton, OH 45408 2007-12-24
1649237553 Jerry Eugene Flexman Clinical Neuropsychologist 1 Elizabeth Place, West Pavilion 1st Floor Suite C, Dayton, OH 45408 2006-04-26
1598722571 William Klykylo Psychiatry & Neurology 627 Edwin C Moses Blvd, East Medical Plaza, Dayton, OH 45408 2006-04-26
1265491930 Healing Touch Home Healthcare Registered Nurse 601 S.edwin C. Moses, East Plaza, Suite 3-i, Dayton, OH 45408 2006-03-21
1023082401 Philip Copelain Williams Jr. Surgery One Elizabeth Place, Suite 10a, Dayton, OH 45408 2006-02-14
1912987256 Heart Hospital of Dto, LLC General Acute Care Hospital 707 S. Edwin C. Moses Blvd, Dayton, OH 45408 2006-01-20
1821076365 Pesso Investments, Ltd Emergency Medicine 707 S. Edwin C. Moses Blvd., Dayton, OH 45408 2006-01-05
1184605727 Benjamin David Shaffer Pharmacist 707 South Edwin C. Moses Blvd., Dayton, OH 45408 2005-11-10
1396974358 The Karrington Company LLC Durable Medical Equipment & Medical Supplies One Elizabeth Place, Dayton, OH 45408 2009-07-10
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659858157 Karen A Evans Phd LLC Psychologist 7061 Corporate Way Ste 110, Dayton, OH 45459-4244 2018-07-26
1891240800 Michelle Vaughan Psychologist 9 N Edwin C Moses, Dayton, OH 45435-8470 2016-08-19
1912376930 Cheryl K. Fender Psychologist 2251 Timber Ln, Dayton, OH 45414-4532 2015-09-21
1053717157 Ramesh Shah Psychologist 9 Bloomfield Ct, Dayton, NJ 08810-1620 2014-11-17
1427468321 Kaitlyn A. Lang Psychologist 200 S Keowee St, Dayton, OH 45402-2242 2014-04-30
1942628946 Mickala Frantz Psychologist 2821 Winburn Ave, Dayton, OH 45420-2259 2014-04-07
1417206954 Cornerstone Project, LLC Psychologist 4124 Linden Ave, Suite 100, Dayton, OH 45432-3018 2012-08-30
1083979769 Carol Ann Fiunk Psychologist 8 Sunset Ct, Dayton, NJ 08810-1622 2012-07-09
1114182037 Maria Noce Psychologist 4100 W 3rd St # 116m, Dayton, OH 45428-9000 2008-07-21
1124224894 Shannon T. Boyer Psychologist 106 S Cleveland St, Dayton, TX 77535 2007-06-21
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Competitor

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City DAYTON
Zip Code 45408

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Dataset Information

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.

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