Individual provider Active NPI

Merna Peterson

  • Mental Health Counselor
  • Gold Beach, OR
National Provider Identifier
1013296920
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
29821 Colvin
Gold Beach, OR 97444
Phone
(541) 247-4082
NPI assigned
Aug 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

29821 Colvin
Gold Beach, OR 97444

Mailing address

PO Box 746
Gold Beach, OR 97444-0746
Phone (541) 247-4082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1013296920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974440746",
            "telephone_number": "541-247-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29821 COLVIN",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "97444",
            "telephone_number": "541-247-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MERNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Beach, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.