Active NPI
Kacey M Peterson, MS, LMHC
- Mental Health Counselor
- Stuart, IA
National Provider Identifier
1043528334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 001334
- Practice address
- 320 NE 3Rd St
Stuart, IA 50250-2157 - Phone
- (641) 247-8114
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 001334 | IA | Primary |
Addresses
Primary practice location
320 NE 3Rd St
Stuart, IA 50250-2157
Mailing address
301 E Grant St
Casey, IA 50048-1011
Phone (641) 247-8114
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001334 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1043528334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E GRANT ST",
"city": "CASEY",
"state": "IA",
"postal_code": "500481011",
"telephone_number": "641-247-8114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 NE 3RD ST",
"city": "STUART",
"state": "IA",
"postal_code": "502502157",
"telephone_number": "641-247-8114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "KACEY",
"middle_name": "M",
"credential": "MS, LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-20",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "001334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stuart, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.