LISA A PETERSON


Address: 110 Elmwood Ave, Providence, RI 02907-2423
Phone: 4014326029

LISA A PETERSON (NPI# 1962514869) 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) 1962514869
Entity Type Individual
Full Name LISA A PETERSON
Credential LMHC LCDP LCDCS MAC
Practice Address 110 Elmwood Ave
Providence
RI 02907-2423
Practice Telephone 4014326029
Practice Fax Number 4013005656
Mailing Telephone 4014326029
Mailing Fax Number 4013005656
Enumeration Date 2006-08-31
Last Update Date 2019-06-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
MHC00235 RI Behavioral Health & Social Service Providers
N 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
LCDP00129 RI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
RI BLUE CROSS 29290 8 01
RI LJ55332 05
RI BLUE CHIP 412210 01

Other Providers LISA PETERSON

NPI Name Taxonomy Address Enumeration
1265952592 Lisa Peterson Physical Therapy Assistant 893 94th St, Pleasant Prairie, WI 53158-4911 2017-06-27
1497154033 Lisa Peterson Speech-Language Pathologist 407 N Foster St, Center, MO 63436-1026 2014-08-20
1528467503 Lisa Peterson Marriage & Family Therapist 3240 W Foster Ave, Suite A, Chicago, IL 60625-4828 2014-08-15
1518204734 Lisa Lynn Peterson Counselor 405 Goldridge Dr, Georgetown, TX 78633-1989 2013-01-08
1790056554 Lisa Peterson Nurse Practitioner 12629 Se 54th St, Bellevue, WA 98006-2916 2012-01-25
1265697676 Lisa Ann Peterson Social Worker 8366 Mary Lee Ln, Laurel, MD 20723-1192 2008-07-24
1619156411 Lisa M Peterson Physician Assistant 1500 14th St W Ste 300, Williston, ND 58801-4079 2007-10-29
1336131986 Lisa M Peterson Internal Medicine 180 W Grange Ave, Milwaukee, WI 53207-6030 2005-08-19
1154983682 Lisa Marie Peterson Counselor 784 High St, San Luis Obispo, CA 93401-5243 2019-07-04
1013480631 Lisa Jane Peterson Speech-Language Pathologist 3430 Burnet Ave # 4011, Cincinnati, OH 45229-2833 2019-01-07

Office Location

Street Address 110 ELMWOOD AVE
City PROVIDENCE
State RI
Zip Code 02907-2423

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861034233 Alexandra Carter Counselor 110 Elmwood Ave, Providence, RI 02907-2423 2019-10-17
1700447331 Kyle Perry Potter Counselor 110 Elmwood Ave, Providence, RI 02907-2423 2019-06-25
1457822413 Victa LLC Clinic/Center 110 Elmwood Ave, Providence, RI 02907-2423 2018-12-16
1316438211 Alexander Donoyan Counselor 110 Elmwood Ave, Providence, RI 02907-2423 2018-05-25
1437428968 Amanda Joye Whitney Counselor 110 Elmwood Ave, Providence, RI 02907-2423 2011-12-29

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518522861 Catherine M Katzberg Massage Therapist Santosha Yoga Studio, 275 Reservoir Ave, Providence, RI 02907 2019-05-02
1104317007 Victa LLC Internal Medicine 110 Elmwood Ave # A, Providence, RI 02907 2018-05-25
1639566987 Southside Elementary Charter School Local Education Agency (LEA) 126 Somerset Street, Providence, RI 02907 2015-04-23
1063846558 Achievement First Providence Mayoral Academy Charter School Local Education Agency (LEA) 370 Hartford Aveneue, Providence, RI 02907 2013-09-03
1912297425 Reynaldo P Baduya Sr.,dmd Clinic/Center 252 Adelaide Avenue, Providence, RI 02907 2011-04-18
1821218587 Map Behavioral Health Serv. Inc. Community/Behavioral Health 66 Burnett Street, Providence, RI 02907 2007-04-26
1548336944 Angelica Redleaf Chiropractor 1196 Elmwood Avenue, Providence, RI 02907 2006-11-28
1174619878 Emilio Rodriguez-peris Internal Medicine 655 Broad Street, Suite 201, Providence, RI 02907 2006-10-04
1841381555 Maged Taman Internal Medicine 21 Peace Street, Providence, RI 02907 2006-09-27
1003924226 Gladys V Rezendes Psychologist 118 Comstock Avenue, Providence, RI 02907 2006-08-28
Find all providers in zip 02907

Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932738416 Rhea Bhatia Counselor 219 Leah St Unit 2, Providence, RI 02908-3907 2020-04-06
1568098721 Roisin Mcgettigan Counselor 365 Hope St, Providence, RI 02906-1633 2020-03-19
1962049932 Wholelife Family Wellness Clinic of Providence Pllc Counselor 169 N Gateway Dr. Suite 170, Providence, UT 84332 2019-12-09
1679117675 Abbey Seabury Chrupcala Counselor 382 Thayer St, Providence, RI 02906-1558 2019-11-01
1205392891 Sara De Carvalho Counselor 21 Pratt St # 5, Providence, RI 02906-1424 2019-02-19
1376008078 Rebecca Zub Counselor 58 Taft Ave Apt 9, Providence, RI 02906-3473 2019-02-06
1821509944 Hologram Central Counselor 44 Barbara St Unit 1, Providence, RI 02909-5110 2017-10-16
1497273932 Ashley Jasmine Williams Counselor 131 Ledge St, Providence, RI 02904-1532 2017-09-05
1912448481 Catherine Allard Counselor 225 Carpenter St, Providence, RI 02903-3044 2017-03-16
1649711144 Kerri Peterson Weaver Counselor 400 Reservoir Ave Ste Llo, Providence, RI 02907-3595 2017-03-16
Find all providers in PROVIDENCE

Competitor

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City PROVIDENCE
Zip Code 02907

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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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