Linda F Peterson, LPC., NCC
Individual provider Active NPI Professional Counselor · Saint Ann, MO
NPI 1174848014 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1174848014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2010009686 (MO)
- Practice address
- 10828 Saint Charles Rock Rd
Saint Ann, MO 63074-1508 - Phone
- (314) 368-2409
- Fax
- (314) 442-4139
- NPI assigned
- Apr 4, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12 Fee Fee Rd
Maryland Heights, MO 63043-2729
Phone (314) 368-2409
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250317000154 | MO | Practitioner - Mental Health Counselor | 5890028419 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010009686 | MO | MD | Professional Counselor |
| 0455347 | MO | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Changes Therapeutics Services | Current |
Accepting new patients | |
| Alpine'S Empowerment Agency, PLLC | Mental Health | Past |
Accepting new patients |
Locations
12 Fee Fee Rd
Maryland Heights, MO 63043
Phone (314) 368-2409
10828 Saint Charles Rock Rd
Saint Ann, MO 63074
Phone (314) 368-2409
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2010009686 | MO | |
| School Counselor | 101YS0200X | 0455347 | MO | |
| Professional Counselor | 101YP2500X | 2010009686 | MO | Yes |
Addresses
Primary practice location
10828 Saint Charles Rock Rd
Saint Ann, MO 63074-1508
Mailing address
523 Sapphire Dr
O Fallon, MO 63366-1889
Phone (314) 368-2409
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49296908 | Medicaid | MO |
Other providers in Saint Ann, MO
- Pattonville School District
- Steven Donald Payne
- Pearle Vision Inc
- People'S Choice in Home Service, Inc.
- Calela Pernell
- Mallorie Peterson
- Precision Home Health Services LLC
- Prestigious Home Health Agency
- Residential Services Corporation
- Richard F Jotte, Inc.
All providers in Saint Ann, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.