PETERSEN ENTERPRISES INC (NPI# 1518356484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518356484 |
| Entity Type | Organization |
| Organization Name | PETERSEN ENTERPRISES INC |
| Other Organization Name | INNOVATIVE NEUROFEEDBACK THERAPY |
| Practice Address |
4529 Stover St Fort Collins CO 80525-3261 |
| Mailing Address |
4213 Durango Pl Fort Collins CO 80526-4103 |
| Practice Telephone | 9702341147 |
| Mailing Telephone | 9702341147 |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |
| Authorized Official Name | MRS. JENNIFER PETERSEN (PRESIDENT) |
| Authorized Official Telephone | 9702341147 |
| Authorized Official Credential | MA, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2179 | CO | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Innovative Neurofeedback Therapy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | PETERSEN ENTERPRISES INC | 4529 Stover, Fort Collins, CO 80525 |
| Street Address |
4529 STOVER ST |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790299527 | Amy Moen | Counselor | 4529 Stover St, Fort Collins, CO 80525 | 2017-12-01 |
| 1598118374 | Edward Doyle | Counselor | 4529 Stover St, Fort Collins, CO 80525-3261 | 2016-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484318 | Kelly Elizabeth Sinning | Counselor | 19 Old Town Sq Ste 272, Fort Collins, CO 80524-2471 | 2020-10-15 |
| 1518516988 | Melissa Marie Gonzales | Counselor | 375 E Horsetooth Rd Ste 101, Fort Collins, CO 80525-3155 | 2019-09-09 |
| 1124674940 | Katie Renee Frisch | Counselor | 649 Sherry Dr, Fort Collins, CO 80524-8513 | 2019-08-16 |
| 1548812142 | Jennifer Lin Meyer | Counselor | 4025 Automation Way Unit D3, Fort Collins, CO 80525-3448 | 2019-07-12 |
| 1427517127 | Melissa Root | Counselor | 2625 Redwing Rd Ste 180, Fort Collins, CO 80526-6324 | 2019-03-13 |
| 1447722111 | Gabrielle Fihn | Counselor | 1600 Specht Point Rd # 108, Fort Collins, CO 80525-4311 | 2018-12-19 |
| 1114408713 | Amy L Myhre | Counselor | 400 Impala Cir Unit 6, Fort Collins, CO 80521-5114 | 2018-08-22 |
| 1881172377 | Chelsea Elizabeth Twiss | Counselor | 1209 W Plum St Apt A6, Fort Collins, CO 80521-3579 | 2018-08-06 |
| 1952887945 | Paul Allan Chubbuck | Counselor | 1010 Morgan St, Fort Collins, CO 80524-3857 | 2018-07-13 |
| 1427541739 | Martha Canji | Counselor | 375 E Horsetooth Rd Ste 111, Fort Collins, CO 80525-3155 | 2018-06-11 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
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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.