Emily Petersen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1569 SW Nancy Way
Bend, OR 97702-3234

Phone

(541) 617-0377

NPI assigned

May 15, 2023

Last updated

May 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1033800727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 SW NANCY WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023234",
            "telephone_number": "541-617-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 SW NANCY WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023234",
            "telephone_number": "541-617-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Pescatore, LPCA
• Peter E. Palacio, M.D., PC
• Peters Dermatology Center
• Daisha Marie Peters
• Gerald E Peters Jr., M.D.
• Kiana Kay Shin-Tze Petersen
• Peterson Performance Products Inc (Peterson's Orthotic Lab)
• Peterson Performance Products, Inc. (Foot Fitness)
• Jake Allen Peterson, DDS, MD
• Jessica Peterson

• Mental Health Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.