Stephen Wayne Peterson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

7400 Metro Blvd Ste 220
Edina, MN 55439-2321

Phone

(952) 220-7164

NPI assigned

Sep 9, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ervin Counseling and Family Life Ministries PAGroup PAC ID 8820530009, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ervin Counseling and Family Life Ministries, P.a.

  • Marriage & Family Therapist
  • Edina, MN
  • NPI 1497880108
  Medicare reassignment Care Compare group NPD
• People Incorporated

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1215104831
  Medicare reassignment NPD
• People Incorporated

  • Community/Behavioral Health Agency
  • New Hope, MN
  • NPI 1720356900
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1003284886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 QUEEN AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 220",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392321",
            "telephone_number": "952-220-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554043378",
            "country_code": "US",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STEPHEN",
        "middle_name": "WAYNE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Christian Peterson, DPM
• Michelle C Peterson, MS LMFT
• Randolph K. Peterson, M.D.
• Robert K Peterson, DDS
• Rodney Holmes Peterson, M.D.
• Tara Peterson, LICSW, LADC
• Patricia Mary Pettit, M.D.
• Carol Jean Pexa, C.R.N.A.
• Chloe G Peyton, MD
• Brianna Marie Pezon, MSW, LICSW, MAOL

• Professional Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.