Active NPI
Ashley Petersen
- Mental Health Counselor
- Waverly, IA
National Provider Identifier
1184192353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 092694
- Practice address
- 106 16TH St SW
Waverly, IA 50677-2822 - Phone
- (319) 352-2630
- NPI assigned
- Nov 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 092694 | IA | Primary |
Addresses
Primary practice location
106 16TH St SW
Waverly, IA 50677-2822
Mailing address
1019 Maplewood Dr Apt 310
Cedar Falls, IA 50613-5366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 092694 | IA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Covenant Medical Center Inc | Past | Accepting new patients |
Interoperability endpoints
- apetersen839003@direct.unitypoint.org
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Family Medicine Physician
- Waterloo, IA
- NPI 1548288160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1184192353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 MAPLEWOOD DR APT 310",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506135366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 16TH ST SW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772822",
"telephone_number": "319-352-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-06",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "092694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.