Carol B. Peterson PH.D., L.P., LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LP3201 Issued in MN

Legal business name

CAROL B. PETERSON PH.D., L.P., LLC

Practice address

5101 Olson Memorial Hwy
Suite 4005
Golden Valley, MN 55422-5149

Phone

(763) 595-7294

Fax

(763) 595-7293

NPI assigned

Jul 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carol Brooke Peterson, PH.D.

Title

Licensed Psychologist

Phone

(763) 595-7294

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114932522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 JAMES AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081822",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 OLSON MEMORIAL HWY",
            "address_2": "SUITE 4005",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554225149",
            "telephone_number": "763-595-7294",
            "fax_number": "763-595-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL B. PETERSON PH.D., L.P., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "763-595-7294",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "LP3201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Solutions
• Connie L. Carlson, LAMFT
• Erin Carlson, RRT
• Leah Carlson, DC
• Melissa Carlsrud, PHARMD
• Jessica A Carr, PTA
• Alyssa Carrier, PT, DPT
• Nicole Casey, LMFT
• Caspersen, LLC (Caspersen Therapy Center)
• Melissa Castro, PSYD, LP, ABPP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.