Marni Anna Peterson, LMFT, DMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4033 Issued in FL

Practice address

322 Marshside Dr N
St Augustine, FL 32080-9152

Phone

(651) 434-4977

NPI assigned

Dec 12, 2022

Sex

Female

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 FL

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

Marriage and Family Therapist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Community Health Services IncGroup PAC ID 0345463683, 54 clinicians

Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• FL PPO

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.

• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  Medicare reassignment Care Compare group NPD
• Coastal Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fernandina Beach, FL
  • NPI 1851131874
  Medicare reassignment Care Compare group NPD
• Coastal Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brunswick, GA
  • NPI 1063282937
  NPD

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1023729993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MARSHSIDE DR N",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320809152",
            "telephone_number": "651-434-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MARSHSIDE DR N",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320809152",
            "telephone_number": "651-434-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARNI",
        "middle_name": "ANNA",
        "credential": "LMFT, DMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "4033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aditya Mani Perumal, PHARM D
• Amudha Mani Perumal, M.D
• Brooke Michelle Perussina, PA C
• Pamela Pessel
• Amie Nichole Peterson, ARNP
• Anthony Robert Petrone, D.M.D.
• Joseph Pezak Jr.
• Vincent C Pfab, RPH
• Julie Pham
• Tom Long Hoang Phan, DPT PT

• Marriage & Family Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.