Individual provider Active NPI

Gabrielle Therese Peterson, LMFT

  • Marriage & Family Therapist
  • Gainesville, FL
National Provider Identifier
1043313463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT001373 Issued in FL
Practice address
2631 NW 41St Street
BLDG E Suite 1
Gainesville, FL 32606
Phone
(352) 367-1110
Fax
(352) 271-4322
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT001373 FL Primary

Addresses

Primary practice location

2631 NW 41St Street
BLDG E Suite 1
Gainesville, FL 32606

Mailing address

4335 SW 83Rd Way
Gainesville, FL 32608
Phone (352) 367-1110

Other identifiers 1

IdentifierTypeStateIssuer
Z3685OtherFLBLUE CROSS BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
MT001373FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gabrielle Peterson, M.S. LMFT PLLC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043313463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 SW 83RD WAY",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32608",
            "telephone_number": "352-367-1110",
            "fax_number": "352-271-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 NW 41ST STREET",
            "address_2": "BLDG E SUITE 1",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32606",
            "telephone_number": "352-367-1110",
            "fax_number": "352-271-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GABRIELLE",
        "middle_name": "THERESE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT001373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z3685",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.