Dale L Peterson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

298385 Issued in KY

Practice address

2218 Eastview Ave
Louisville, KY 40205-2663

Phone

(410) 688-6377

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in KY

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

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Mind Body Sport, LLC

  • Professional Counselor
  • Denver, CO
  • NPI 1497273916
  NPD (past)
• Morgan Metro Maryland Counseling Ctr

  • Psychologist
  • Timonium, MD
  • NPI 1194937466
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776556800000",
    "number": "1023234572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 EASTVIEW AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2218 EASTVIEW AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052663",
            "telephone_number": "410-688-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DALE",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2026-04-19",
        "certification_date": "2026-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "4759",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "298385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy F. Petersen, D.C.
• Peterson Medical Transportation LLC
• Peterson Psychological Services, PLLC
• Anna L Peterson
• Carol B Peterson, ED. D.
• Edwina Peterson
• Eleanor B Peterson, M.D.
• Hanna V. Peterson, MD
• Hugh Peterson Jr., MD
• Jane Peterson

• Clinical Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2026; 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.