LISA PETERSEN (NPI# 1942704127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942704127 |
| Entity Type | Individual |
| Full Name | LISA PETERSEN |
| Other Name | LISA MALLORY |
| Credential | LCMHC |
| Practice Address |
1138 Pine St Burlington VT 05401-5353 |
| Mailing Address |
208 Flynn Ave Ste 3j Burlington VT 05401-5420 |
| Practice Telephone | 8024886600 |
| Practice Fax Number | 8024886919 |
| Mailing Telephone | 8024886920 |
| Mailing Fax Number | 8024886919 |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
068-01288884 | VT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407239338 | Lisa Petersen | Pharmacist | 213 Calumet Ave Sw, De Smet, SD 57231-2161 | 2015-07-09 |
| 1609141209 | Lisa Petersen | Registered Nurse | 191 Vermont Ave, Staten Island, NY 10305-1727 | 2012-03-14 |
| 1184620957 | Lisa Jo Petersen | Family Medicine | 933 Red Apple Rd Ste D, Central Washington Hospital Women's Healthcare Center, Wenatchee, WA 98801-3370 | 2005-06-24 |
| 1831734961 | Lisa Irene Petersen | Occupational Therapist | 125 Middletown Rd, Waterford, NY 12188-1516 | 2019-11-13 |
| 1063707305 | Lisa M Petersen | Counselor | 801 Harmony St, Suite 302, Council Bluffs, IA 51503-3106 | 2011-06-15 |
| 1982917209 | Lisa R Petersen | Optometrist | 280 Exempla Cir, Lafayette, CO 80026-3370 | 2010-07-15 |
| 1699813923 | Lisa Petersen | Psychologist | 601 University Ave, Suite #225, Sacramento, CA 95825-6775 | 2007-02-01 |
| Street Address |
1138 PINE ST |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-5353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043328180 | Grace Marie Mignosa | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2006-08-28 |
| 1417556291 | Alexandra Altman | Psychologist | 1138 Pine St, Burlington, VT 05401-5353 | 2020-10-22 |
| 1609473123 | Lena Freed | Counselor | 1138 Pine St, Burlington, VT 05401-5353 | 2020-10-07 |
| 1811594013 | Annalee Pratt | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-10-01 |
| 1467064378 | Nyarkoa Mensah-jordan | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-08-21 |
| 1891304077 | Brian Barrows | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-07-23 |
| 1225653884 | Kiresten Parks | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-06-10 |
| 1013539576 | Lisa Rounds | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-05-07 |
| 1164057535 | Jennifer Sturgis | Behavioral Analyst | 1138 Pine St, Burlington, VT 05401-5353 | 2020-03-06 |
| 1457983611 | Krysten Farrell | Social Worker | 1138 Pine St, Burlington, VT 05401-5353 | 2020-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950984 | Keith Edward Smith | Counselor | 288 Flynn Ave Apt 26, Burlington, VT 05401-5370 | 2020-07-29 |
| 1528677325 | Gavin B Chadwell | Counselor | 337 College St Ste G, Burlington, VT 05401-8344 | 2020-07-28 |
| 1407473549 | Christine Borzumato-gainey | Counselor | 3643 Liberty Dr, Burlington, NC 27215-9387 | 2020-07-05 |
| 1669096434 | Callie Douglass | Counselor | 337 College St, Burlington, VT 05401-8344 | 2020-06-08 |
| 1144870742 | Amy Cronin | Counselor | 20 Oak St Apt 2, Burlington, VT 05401-2828 | 2019-09-16 |
| 1760948251 | Path Integrated Healthcare | Counselor | 125 College St Ste 300, Burlington, VT 05401-8444 | 2019-02-20 |
| 1255800082 | William Hayes Davenport | Counselor | 269 Pearl St Ste 4, Burlington, VT 05401-8536 | 2018-11-22 |
| 1821574443 | Dana Rochelle Hays | Counselor | 6272 Woodcrest Dr, Burlington, KY 41005-8444 | 2018-07-17 |
| 1265937650 | Jennifer L Kerns | Counselor | 269 Pearl St Ste 3, Burlington, VT 05401-8536 | 2018-03-27 |
| 1205335130 | Lynn Ruth Martin | Counselor | 130 Mansfield Ave Apt 201, Burlington, VT 05401-3396 | 2018-02-06 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
Please comment or provide details below to improve the information on LISA PETERSEN.
| 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.