MR. KEVIN LEE PETERSEN (NPI# 1578759270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578759270 |
Entity Type | Individual |
Full Name | MR. KEVIN LEE PETERSEN |
Credential | LMHC |
Practice Address |
401 16th St Se Rochester MN 55904-7973 |
Practice Telephone | 5073154184 |
Practice Fax Number | 5075160031 |
Mailing Telephone | 5073154184 |
Mailing Fax Number | 5075160031 |
Enumeration Date | 2007-09-18 |
Last Update Date | 2020-03-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
00399 | IA | Behavioral Health & Social Service Providers |
Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP6513 | MN | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356778419 | Kevin Thomas Petersen | Surgery | 620 John Paul Jones Cir Dept General, Portsmouth, VA 23708-2197 | 2013-10-03 |
1457655680 | Kevin W Petersen | Marriage & Family Therapist | 1420 S Clarkson St, Denver, CO 80210-2237 | 2011-01-03 |
1255861126 | Kevin Scott Petersen | Physical Therapist | 3160 8th St Sw Ste M&n, Altoona, IA 50009-1023 | 2017-06-14 |
1356676290 | Kevin Leon Petersen | Psychologist | 6439 Garners Ferry Road, Wjbd Va Medical Center, Columbia, SC 29209 | 2009-10-09 |
1851414346 | Kevin E. Petersen | Chiropractor | 29 Lake St S, Big Lake, MN 55309-4588 | 2007-04-09 |
1205971066 | Kevin Petersen | Specialist | 653 N Town Center Dr, Las Vegas, NV 89144-0514 | 2007-02-20 |
Street Address |
401 16TH ST SE |
City | ROCHESTER |
State | MN |
Zip Code | 55904-7973 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114991361 | Kimberly E Henderson | Nurse Practitioner | 401 16th St Se, Rochester, MN 55904-7973 | 2006-02-15 |
1548771975 | Britne Weiher | Social Worker | 401 16th St Se, Rochester, MN 55904-7973 | 2017-10-12 |
1003211400 | Lacy Osborne | Social Worker | 401 16th St Se, Rochester, MN 55904-7973 | 2014-10-28 |
1609208826 | Chad Evans Larson | Dentist | 401 16th St Se, Rochester, MN 55904-7973 | 2013-07-30 |
1790983161 | Richard L Sprague | Social Worker | 401 16th St Se, Rochester, MN 55904-7973 | 2007-07-06 |
1275667123 | Arnold J Hill | Dentist | 401 16th St Se, Rochester, MN 55904-7973 | 2007-03-15 |
1891829669 | Ta Guenthner, Dds Msd and Be Larson, Dds, Ms, Pa | Clinic/Center | 401 16th St Se, Rochester, MN 55904-7973 | 2007-03-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558912303 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1200 Eastgate Drive S.e., Rochester, MN 55904 | 2019-09-24 |
1952954992 | Jane Yaakni Hopaki | Midwife | 1224 Eastgate Dr Se, Rochester, MN 55904 | 2019-07-18 |
1851896187 | Hamdi A Ali | Pediatrics | 26 Mayo Park Dr Se, Rochester, MN 55904 | 2018-03-28 |
1255847059 | Brooke Maleszewski | Nurse Practitioner | 821 3rd Ave Se Ste 15, Rochester, MN 55904 | 2017-12-17 |
1699215988 | Maximus Language Resources | Interpreter | 1775 3rd Ave Se, Rochester, MN 55904 | 2017-03-06 |
1215484803 | Kylene Starr Allen | Social Worker | 343 Woodlake Dr. Se, Zumbro Valley Health Center, Rochester, MN 55904 | 2016-09-01 |
1013384627 | Breathe Easy Medical Supplies Inc. | Durable Medical Equipment & Medical Supplies | 40 16th St. Sw Suite G, Rochester, MN 55904 | 2015-08-31 |
1932473105 | Michelle Lee Sather | Counselor | 343 Woodlake Drive Se, Rochester, MN 55904 | 2012-03-05 |
1538453022 | Amy M Carey | Social Worker | 40 16th Street Sw, Suite D, Rochester, MN 55904 | 2011-06-02 |
1396059895 | Lisa Marie Bingham | Optometrist | 111 S. Broadway, Rochester, MN 55904 | 2010-07-27 |
Find all providers in zip 55904 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346883873 | Denise Pine | Psychologist | 1111 Elmwood Ave # D3, Rochester, NY 14620-3005 | 2019-10-28 |
1205305729 | Christopher Corona | Psychologist | 100 Linden Oaks, Suite 102, Rochester, NY 14625 | 2018-11-14 |
1275017550 | Leah Rothschild | Psychologist | 160 Allens Creek Rd Ste 160, Rochester, NY 14618-3312 | 2018-09-21 |
1639658693 | Garry Linsis Spink Jr. | Psychologist | 100 Pinewild Dr Fl 2, Rochester, NY 14606-4200 | 2018-08-10 |
1942798129 | Rachel Marie Rodorigo | Psychologist | 900 W University Dr Ste B3, Rochester, MI 48307-1817 | 2018-04-24 |
1740799162 | Douglas Andrew Raynor | Psychologist | 919 Winton Rd S Ste 106, Rochester, NY 14618-1633 | 2017-09-28 |
1356861884 | Lauren P Wadsworth | Psychologist | 21 Goodway Dr, Rochester, NY 14623-3029 | 2017-06-26 |
1881120947 | Dayton Walsh | Psychologist | 190 Goodman St S, Rochester, NY 14607-2651 | 2017-05-11 |
1770019713 | Brenna Cavanaugh | Psychologist | 200 East River Rd., Rochester, NY 14623 | 2017-05-11 |
1275068470 | Tara Marie Augenstein | Psychologist | University of Rochester, Dept. of Psychiatry, 300 Crittenden Blvd, Rochester, NY 14642 | 2017-04-25 |
Find all providers in ROCHESTER |
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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.