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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
RI | BLUE CROSS | 29290 8 | 01 |
RI | LJ55332 | 05 | |
RI | BLUE CHIP | 412210 | 01 |
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 |
Street Address |
110 ELMWOOD AVE |
City | PROVIDENCE |
State | RI |
Zip Code | 02907-2423 |
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 |
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 Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
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 |
City | PROVIDENCE |
Zip Code | 02907 |
Please comment or provide details below to improve the information on LISA A PETERSON.
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.