Peter Douglas Nordstrom, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH6961 Issued in FL

Practice address

114 St Clair Abrams Ave
Tavares, FL 32778

Phone

(352) 253-6300

Fax

(352) 343-7691

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033180849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 ABACO DR",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784757",
            "telephone_number": "352-253-6300",
            "fax_number": "352-343-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ST CLAIR ABRAMS AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-253-6300",
            "fax_number": "352-343-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "PETER",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z003A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Tavares, FL
• Providers in Tavares, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.