Danielle E Peterson, CSAC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3198-226 Issued in WI

Practice address

429 W Broadway Ave
Medford, WI 54451-1608

Phone

(715) 748-4312

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Danielle E Lissner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1255875654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E BROADWAY AVE APT A",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511586",
            "telephone_number": "715-965-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511608",
            "telephone_number": "715-748-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15701 County Road K",
            "address_2": "Box 130",
            "address_purpose": "LOCATION",
            "city": "Darlington",
            "state": "WI",
            "postal_code": "535309207",
            "country_code": "US",
            "telephone_number": "608-776-4940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANIELLE",
        "middle_name": "E",
        "credential": "CSAC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17253-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7067-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3198-226",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16281-132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "LISSNER",
            "middle_name": "E",
            "credential": "CSAC, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PDQ Medical Transit LLC
• Todd A Peissig, R.PH
• Thomas W Perendy, DPM
• Jessica Pernsteiner
• Tracy Renee Pernsteiner
• Karen Pierce, CPM
• Sheala Rae Pinter, NP
• Jessica L Pipkorn, M.S. CCC-SLP
• Sarah Porten, C.O.T.A.
• Gary Robert Probst, LPC

• Professional Counselor in Medford, WI
• Providers in Medford, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.