MRS. KATHLEEN ANN PETERSEN (NPI# 1972100626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972100626 |
| Entity Type | Individual |
| Full Name | MRS. KATHLEEN ANN PETERSEN |
| Credential | MS, CCC-SLP |
| Practice Address |
407 3rd St Se Minot ND 58701-4470 |
| Practice Telephone | 7018575514 |
| Mailing Telephone | 7018575514 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 347 | ND | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053747576 | Kathleen C Petersen | Social Worker | 591 Columbia Ave, Des Plaines, IL 60016-3062 | 2013-09-16 |
| 1518023803 | Kathleen Geryl Petersen | Psychologist | 7106 Dale Avenue, St. Louis, MO 63117-1927 | 2006-12-29 |
| 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 |
| Street Address |
407 3RD ST SE |
| City | MINOT |
| State | ND |
| Zip Code | 58701-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073571022 | Michael G Rayel | Psychiatry & Neurology | 407 3rd St Se, Minot, ND 58701-4470 | 2006-05-01 |
| 1609482678 | Linnea Maxfield | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2020-09-16 |
| 1871104711 | Rodney James Nogosek | Counselor | 407 3rd St Se, Minot, ND 58701-4470 | 2020-08-13 |
| 1316557242 | Amy Thull | Counselor | 407 3rd St Se, Minot, ND 58701-4470 | 2020-08-05 |
| 1053921999 | Luis Valencia Coca IIi | Counselor | 407 3rd St Se, Minot, ND 58701-4470 | 2020-08-05 |
| 1235771981 | Bethany Richardson | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2019-10-15 |
| 1952961724 | Kristy Burchell | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2019-06-14 |
| 1952803603 | Catherine Oconnell | Occupational Therapist | 407 3rd St Se, Minot, ND 58701-4470 | 2018-03-08 |
| 1003356890 | Lauren Shaw | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2017-02-28 |
| 1376091231 | Kinley Mary Michele Wolfe | Speech-Language Pathologist | 407 3rd St Se, Minot, ND 58701-4470 | 2016-09-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767926 | Minot Commission On Aging, Inc | In Home Supportive Care | 21 1st Avenue Se, Minot, ND 58701 | 2020-10-16 |
| 1780207647 | Growing Together Inc | Counselor | 515 19 Ave Sw, Minot, ND 58701 | 2020-05-26 |
| 1144867847 | Sarah Howard | Registered Nurse | 1015 South Broadway, Ste. 2, Minot, ND 58701 | 2019-12-02 |
| 1962973453 | Julia Irene Lakoduk | Speech-Language Pathologist | Bell Elementary, 5901 Us-52, Minot, ND 58701 | 2018-12-10 |
| 1073000469 | Goodman Addiction Services | Counselor | 1809 South Broadway Suite S., Minot, ND 58701 | 2018-04-20 |
| 1811405988 | Mackenzie J Jones Pllc | Chiropractor | 1407 S Broadway Ste 123, Minot, ND 58701 | 2018-01-11 |
| 1265957617 | Cassandra Czerwonka | Behavioral Analyst | 1408 20th Ave Sw, Suite 7, Minot, ND 58701 | 2017-08-07 |
| 1689197493 | Rem North Dakota | Intermediate Care Facility, Mentally Retarded | 1905 2nd Street Se, Suite 1a, Minot, ND 58701 | 2017-07-24 |
| 1558890236 | Timothy J Corrigan | Chiropractor | 1418 S Broadway Ste C, Minot, ND 58701 | 2017-06-07 |
| 1265826036 | Premier Physical Therapy of North Dakota Pllc | Physical Therapist | 1715 South Broadway, Minot, ND 58701 | 2015-03-19 |
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| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255895835 | Emily Stephens | Speech-Language Pathologist | 2215 8th St Nw, Minot, ND 58703-0926 | 2019-01-28 |
| 1962973453 | Julia Irene Lakoduk | Speech-Language Pathologist | Bell Elementary, 5901 Us-52, Minot, ND 58701 | 2018-12-10 |
| 1760974091 | Anna Marie Sanderford | Speech-Language Pathologist | 108 1st Ave Se Apt 320, Minot, ND 58701-3965 | 2018-06-01 |
| 1124539291 | Katelyn Rose Fornshell | Speech-Language Pathologist | 2000 5th Ave Sw, Minot, ND 58701-3510 | 2017-10-17 |
| 1912446923 | Kristin Mary Gillig Casallas | Speech-Language Pathologist | 600 17th Ave Se, Minot, ND 58701-6756 | 2017-02-23 |
| 1316484173 | Maritza Garza | Speech-Language Pathologist | 1370 20th Ave Sw, Minot, ND 58701-6452 | 2017-01-31 |
| 1093267346 | Kara J Nunziato | Speech-Language Pathologist | 1215 36th Ave Nw, Minot, ND 58703-0583 | 2016-11-02 |
| 1245781343 | Anna Skarphol | Speech-Language Pathologist | 3400 13th St Se, Minot, ND 58701-4520 | 2016-10-24 |
| 1760933345 | Faye M Johnson | Speech-Language Pathologist | 501 25th St Nw, Minot, ND 58703-1869 | 2016-10-19 |
| 1174971246 | Mackenzie Bachmeier | Speech-Language Pathologist | 2201 36th Ave Sw Ste B, Minot, ND 58701-7593 | 2016-05-31 |
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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.