Edi M Peterson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001758 Issued in NY

Practice address

44 E 32ND St
11TH Floor TRS Professional Suites
New York, NY 10016-5508

Phone

(212) 685-2848

NPI assigned

Aug 1, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Tri State Counseling and Mediation LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1487738761
  NPD (past)

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1295991990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HARBOR VIEW TER",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201187",
            "telephone_number": "201-312-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E 32ND ST",
            "address_2": "11TH FLOOR TRS PROFESSIONAL SUITES",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165508",
            "telephone_number": "212-685-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EDI",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001758",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00359600",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "16071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecil Broady Peterson, M.D.
• Christine J. Peterson, M.D.
• Connor Michael Peterson
• Dana Nicole Peterson, SLP
• Douglas Peterson, M.SC., L.AC
• Elaine Peterson
• Erik Peterson, MD
• Jenna Peterson
• Keri L Peterson, MD
• Kristen Terese Peterson, PHARMD

• Mental Health Counselor in New York, NY
• Providers in New York, 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 Aug 1, 2008; 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.