William C Petersen, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

01531 Issued in MO

Practice address

5351 Delmar Blvd
Saint Louis, MO 63112-3146

Phone

(314) 877-0685

Fax

(314) 877-0553

NPI assigned

Oct 17, 2006

Last updated

Jun 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1124109400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7106 DALE AVE",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171927",
            "telephone_number": "314-647-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5351 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123146",
            "telephone_number": "314-877-0685",
            "fax_number": "314-877-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "01531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew James Petersen, ATC
• Max Christian Petersen, MD
• Rebecca Jo Petersen, FNP
• Rebecca Y. Petersen, MD
• Robert Lynn Petersen, MD
• Danielle Lee Petersmith, CRNA
• Alexandria Elizabeth Peterson, PA
• Andrew Michael Peterson, MD
• Annahita Peterson, MD, MSCI
• Brian G Peterson, MD

• Counseling Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Counseling Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.