Individual provider Active NPI

Britt Ann Peterson, PH.D.

  • Clinical Psychologist
  • Brookfield, WI
National Provider Identifier
1306158001
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2748057 Issued in WI
Practice address
16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936
Phone
(262) 542-3255
Fax
(262) 821-6180
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 2748057 WI
Clinical Psychologist 103TC0700X 2748057 WI Primary
Health Psychologist 103TH0004X 2748057 WI
Group Psychotherapy Psychologist 103TP2701X 2748057 WI

Addresses

Primary practice location

16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936

Mailing address

16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936
Phone (262) 542-3255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000242 WI Practitioner - Clinical Psychologist 6305961822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5906
Phone (262) 789-1191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2748057WIMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Jul 3, 2010 Accepting new patients

Locations

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.brittpeterson@149809.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1306158001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055936",
            "telephone_number": "262-542-3255",
            "fax_number": "262-821-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 W BLUEMOUND RD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530055936",
            "telephone_number": "262-542-3255",
            "fax_number": "262-821-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRITT",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "2748057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2748057",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "WI",
            "license": "2748057",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WI",
            "license": "2748057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.