Jonathan David Peters, MA, LPCC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC03364 Issued in MN

Practice address

867 N Dearborn St
Chicago, IL 60610-3310

Phone

(800) 257-7800

Fax

(312) 943-3530

NPI assigned

Jun 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1003547977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5534 N KENMORE AVE APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401544",
            "telephone_number": "612-810-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 N DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103310",
            "telephone_number": "800-257-7800",
            "fax_number": "312-943-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "credential": "MA, LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304604",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Marie Peters, AGACNP-BC
• Emily Peters
• Erika Peters
• Georgina Marie Peters, LMFT
• Jeffrey W Peters, OD
• Kelly Ann Peters, LCPC
• Kerry Peters, OTR/L
• Kolawole Peters
• Kristin Marie Peters, LCPC, LPC, SAC
• Neill T Peters, M.D.

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.