Amelia Reeves Peterson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

010081 Issued in NY

Practice address

184 N River Rd
Fort Edward, NY 12828-2902

Phone

(978) 712-8661

NPI assigned

Dec 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amelia Trainor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 5, 2024 through Apr 5, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Meghan M. Tobin, Licensed Mental Health Counselor, PC

  dba Breathing Space Psychotherapy

  • Mental Health Counselor
  • Erieville, NY
  • NPI 1164902078
  NPD (past)

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

{
    "created_epoch": "1608854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1215524103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 N RIVER RD",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128282902",
            "telephone_number": "518-817-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 N RIVER RD",
            "city": "FORT EDWARD",
            "state": "NY",
            "postal_code": "128282902",
            "telephone_number": "978-712-8661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Main St",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "NY",
            "postal_code": "128341211",
            "country_code": "US",
            "telephone_number": "978-712-8661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "AMELIA",
        "middle_name": "REEVES",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-25",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELIA",
            "last_name": "TRAINOR",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Moreau Emergency Squad Inc
• Bonnie Summers Ovitt, LPN
• William M Parker, MD
• Ashley Perez, RN
• Holly Perue, LMSW
• Lauren Gisela Petosa, LMSW
• Gayle J Pliscofsky, O.T.
• Sandra Pollaro, LCSW-R
• Mary Sheldon Price, MSCCCSLP
• Stephanie Ann Railey, LMSW

• Mental Health Counselor in Fort Edward, NY
• Providers in Fort Edward, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.