NPIMap

Organization Active NPI

La Familia Counseling Services

  • Professional Counselor
  • Jackson, WY
National Provider Identifier
1053771287
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1071 Issued in WY
Legal business name
LA FAMILIA COUNSELING SERVICES
Practice address
140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632
Phone
(307) 413-6528
NPI assigned
Mar 1, 2016
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Daniela Francisca Peterson, LPCNPI 1598807760
Title
Owner
Phone
(307) 413-6528

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1071 WY Primary
Psychologist 103T00000X 136 WY

Addresses

Primary practice location

140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632

Mailing address

825 Hi Country Dr
Jackson, WY 83001-9442
Phone (307) 413-6528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200715002492 WY Part B Supplier - Clinic/Group Practice 3375967987 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, WY

National Provider Directory

National Provider Directory
Tax ID family
La Familia Counseling Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1053771287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 HI COUNTRY DR",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830019442",
            "telephone_number": "307-413-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E BROADWAY AVE STE B-13",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018632",
            "telephone_number": "307-413-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FAMILIA COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DANIELA",
        "authorized_official_middle_name": "FRANCISCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-413-6528",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "1071",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WY",
            "license": "136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.