Individual provider Active NPI

Susan Peterman, PLPC, MHP, LPC

  • Professional Counselor
  • Lafayette, LA
National Provider Identifier
1124491626
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6222 Issued in LA
Practice address
113 Stable Creek Dr
Lafayette, LA 70506-5022
Phone
(337) 501-9646
NPI assigned
Nov 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 6222 LA Primary

Addresses

Primary practice location

113 Stable Creek Dr
Lafayette, LA 70506-5022

Mailing address

113 Stable Creek Dr
Lafayette, LA 70506-5022

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260604004120 LA Practitioner - Mental Health Counselor 0446721906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

107 Faculty Dr
Lafayette, LA 70506-6134

184 Williamsburg St
Lake Charles, LA 70605-5720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6222LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Management Services, Inc. of Southwest Louisiana Mental Health Past Accepting new patients
Insight Guidance Group Mental Health Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1124491626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 STABLE CREEK DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 STABLE CREEK DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065022",
            "telephone_number": "337-501-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "SUSAN",
        "credential": "PLPC, MHP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "6222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.