DR. KATHLEEN GERYL PETERSEN (NPI# 1518023803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518023803 |
| Entity Type | Individual |
| Full Name | DR. KATHLEEN GERYL PETERSEN |
| Credential | PH.D. |
| Practice Address |
7106 Dale Avenue St. Louis MO 63117-1927 |
| Mailing Address |
7106 Dale Ave Richmond Heights MO 63117-1927 |
| Practice Telephone | 3146475522 |
| Practice Fax Number | 3148270067 |
| Mailing Telephone | 3146475522 |
| Mailing Fax Number | 3148270067 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2010-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | PYRO278 | MO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053747576 | Kathleen C Petersen | Social Worker | 591 Columbia Ave, Des Plaines, IL 60016-3062 | 2013-09-16 |
| 1063476539 | Kathleen Petersen | Physical Therapist | 491 E 8th Ave, Homestead, PA 15120-1901 | 2006-04-13 |
| 1487632675 | Kathleen B Petersen | Obstetrics & Gynecology | 5 Caldwell Rd, Augusta, ME 04330-5739 | 2006-01-06 |
| 1972100626 | Kathleen Ann Petersen | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2020-10-06 |
| Street Address |
7106 DALE AVENUE |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63117-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| 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 |
|---|---|---|---|---|
| 1134446602 | Donald Trevor Cross | Psychologist | #7 Beverly Place, St. Louis, MO 63112 | 2010-04-23 |
| 1093049694 | Lauren C Mensie | Psychologist | 1 Jefferson Barracks Dr., 116b/jb St. Louis Va Medical Center, St. Louis, MO 63125 | 2009-09-29 |
| 1700497583 | Alexa Beck | Psychologist | One Children's Place, Department of Psychology, Suite 3n-14, St. Louis, MO 63110 | 2020-08-13 |
| 1699143412 | Jessica L. Harvath | Psychologist | 11144 Tesson Ferry Rd Ste 101, St. Louis, MO 63123-6965 | 2015-09-10 |
| 1043500507 | Debra H Zand | Psychologist | 1465 S Grand Blvd, St. Louis, MO 63104-1003 | 2011-04-18 |
| 1205088721 | Kasey L Davis | Psychologist | One Children's Place, Suite 3n-14, St. Louis, MO 63110-1077 | 2008-10-15 |
| 1649375965 | Robert Rocco Cottone | Psychologist | 1 University Blvd, 469 Mh, St. Louis, MO 63121 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894427 | Shraddha Niphadkar | Psychologist | 406 South 6th Street 119 Parker Hall, Columbia, MO 65211-0001 | 2020-09-01 |
| 1750994547 | Ashley Brauer | Psychologist | 231 W Lockwood Ave Ste 202, Saint Louis, MO 63119-2951 | 2020-08-31 |
| 1316559594 | Core Therapy & Diagnostics, LLC | Psychologist | 186 S Payne Stewart Dr Ste 151, Branson, MO 65616-2792 | 2020-08-19 |
| 1538770284 | Meigs Psychological Services LLC | Psychologist | 529 Newport Ave, Saint Louis, MO 63119-2517 | 2020-08-14 |
| 1235748773 | Kendra Krietsch | Psychologist | 1 Childrens Pl # 3n-14, Saint Louis, MO 63110-1002 | 2020-07-30 |
| 1427674001 | Laura Ellen Glover-orr | Psychologist | 5719 Delor St, Saint Louis, MO 63109-2831 | 2020-06-19 |
| 1154941359 | Kimberly Hinman | Psychologist | 17 W 66th St, Kansas City, MO 64113-1825 | 2020-04-17 |
| 1376069674 | Petra Jo Mcguire | Psychologist | 2104 S Garrison Ave, Carthage, MO 64836-3614 | 2017-08-17 |
| 1740701762 | Krownapple Kare, PC | Psychologist | 3400 South Jefferson, St Louis, MO 63118-3120 | 2017-06-29 |
| 1902338304 | James Feinberg | Psychologist | 10900 Manchester Rd Ste 201, Kirkwood, MO 63122-1200 | 2017-04-03 |
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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.