Bonnie Sue Peterson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2102267 Issued in OH

Practice address

601 Cleveland Ave NW
Canton, OH 44702-1836

Phone

(330) 455-0374

Fax

(330) 453-6716

NPI assigned

Oct 31, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commquest Services, Inc.Group PAC ID 9335110824, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Commquest Services, Inc.

  • Multi-Specialty Clinic/Center
  • Canton, OH
  • NPI 1730168311
  Medicare reassignment Care Compare group NPD
• Commquest Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1841550696
  NPD

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1073025946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021836",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Cleveland Ave NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447021805",
            "country_code": "US",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BONNIE",
        "middle_name": "SUE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2102267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273674",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter G Michalos DDS Inc
• Peter G Michalos DDS Inc.
• Jessica Antoinette Peternelj- Monea, M.A., LPCC
• Christina M Peters, RN
• Amanda Lynn Petersen, CDCA
• Cherrelle L Peterson
• Darryl Wayne Peterson II
• Deonna Peterson
• Desirea Peterson
• John Peterson, LISW, CDCA

• Professional Counselor in Canton, OH
• Providers in Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.