Lisa Mae Peters, CP60535132

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60535132 Issued in WA

Practice address

1905 4TH Ave E Ste B
Olympia, WA 98506-4631

Phone

(360) 338-0600

Fax

(360) 338-0601

NPI assigned

Sep 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• First Things First 123 LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Olympia, WA
  • NPI 1124392618
  NPD
• Cascade Community Healthcare

  • Community/Behavioral Health Agency
  • Centralia, WA
  • NPI 1619068624

  Mental Health

  NPD (past)
• Cascade Evaluation and Treatment Center

  • Mental Illness Community Based Residential Treatment Facility
  • Centralia, WA
  • NPI 1760979298
  NPD (past)

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1194194233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 4TH AVE E STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985064631",
            "telephone_number": "360-338-0600",
            "fax_number": "360-338-0601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Laurel St",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "WA",
            "postal_code": "985842151",
            "country_code": "US",
            "telephone_number": "360-490-2181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "WA",
            "postal_code": "985842255",
            "country_code": "US",
            "telephone_number": "360-426-0890",
            "fax_number": "360-426-4688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "LISA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "CP60535132",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2022-10-26",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60535132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107411",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Jason Thomas Perry, MD
• Terri Lynn Perry, LMP
• Cindy Perryman, MFT
• Angela Josefina Peters
• Jessica Rose Peters, D.C
• Nicole Peters
• Samantha Sue Petersen-Hobbs, CMHC
• Dana M Petersen, M.D.
• Iris Havlina Donovan Petersen, MD
• Morrigan Piper Petersen, CPC

• Addiction (Substance Use Disorder) Counselor in Olympia, WA
• Providers in Olympia, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.