DIANE PETERSEN (NPI# 1821227141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821227141 |
| Entity Type | Individual |
| Full Name | DIANE PETERSEN |
| Credential | LMHC |
| Practice Address |
2020 Talley Rd Leesburg FL 34748-3426 |
| Mailing Address |
204 Westwood Dr Leesburg FL 34748-8753 |
| Practice Telephone | 3523157800 |
| Practice Fax Number | 3523606582 |
| Mailing Telephone | 3523157800 |
| Mailing Fax Number | 3523606582 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2020-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | MH 9521 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306187117 | Diane Petersen | Social Worker | 18640 W Il Route 120, Grayslake, IL 60030-9733 | 2013-03-05 |
| 1669514980 | Diane Durkin Petersen | Social Worker | 1299 Olentangy River Rd, Columbus, OH 43212-3135 | 2007-02-13 |
| 1013939578 | Diane Elaine Bergman Petersen | Specialist | 940 Central Park Drive, #209, Steamboat Springs, CO 80487 | 2006-07-24 |
| 1790719342 | Diane M Petersen | Obstetrics & Gynecology | 1031 Bellevue Ave, Suite 400, Saint Louis, MO 63117-1818 | 2006-07-10 |
| 1992734420 | Diane Yvonne Petersen | Otolaryngology | 3565 Del Amo Blvd, 3rd Floor, Torrance, CA 90503-1637 | 2006-06-30 |
| Street Address |
2020 TALLEY RD |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-3426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902802002 | Lifestream Behavioral Center Inc | Psychiatric Residential Treatment Facility | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2005-06-23 |
| 1013421569 | Saad Siddiqui | Physician Assistant | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-11-20 |
| 1801310602 | Lindsey Pollen | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-08-02 |
| 1619409463 | Julia M Palomino | Social Worker | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-03-31 |
| 1285175059 | Olga Rodriguez-burgos | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2017-03-14 |
| 1093258642 | Nageley Michel | Nurse Practitioner | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-11-30 |
| 1518310630 | Michelle Joop | Social Worker | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-07-14 |
| 1871940783 | Abid Darr | Psychiatry & Neurology | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-05-20 |
| 1063871572 | Steven Dolliver | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-02-12 |
| 1518326180 | Darla Peters | Counselor | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2016-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457507048 | Michael Scott Oberschneider | Psychologist | 171 Alpine Dr Se, Leesburg, VA 20175-6167 | 2008-08-14 |
| 1184819963 | Michelle Elizabeth Bruce | Psychologist | 102 Heritage Way, Suite 302, Leesburg, VA 20176-4544 | 2007-09-13 |
| 1801824008 | Jimmy D Shaddock | Psychologist | 1344 Us Highway 19 S, Leesburg, GA 31763-4867 | 2006-06-28 |
| 1265434534 | The Memory Doctor, LLC | Psychologist | 26540 Ace Ave Ste E-106, Leesburg, FL 34748-8279 | 2005-06-01 |
| 1427422385 | Loudoun Psychological Services, LLC | Psychologist | 217 S King St, Leesburg, VA 20175-2905 | 2015-11-16 |
| 1306274691 | Christine Kalchthaler | Psychologist | 15d Loudoun St Sw, Leesburg, VA 20175-2908 | 2013-10-23 |
| 1306278064 | Brenda Crellen | Psychologist | 2020 Talley Rd, Leesburg, FL 34748-3426 | 2013-08-05 |
| 1992081483 | J. Sebastian Tezna | Psychologist | 1 E Market St, 200, Leesburg, VA 20176-3014 | 2011-10-27 |
| 1780824730 | Magaly Delgado | Psychologist | 501 Medical Plaza Dr, Suite 102, Leesburg, FL 34748-7324 | 2009-03-04 |
| 1588812259 | Nina Darlene Lynch | Psychologist | 102 Heritage Way Ne, Suite 302, Leesburg, VA 20176-4544 | 2008-09-05 |
| Find all providers in LEESBURG | ||||
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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.