Kent G. Peterson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 00547 Issued in FL

Practice address

1817 Crescent Blvd Ste 101D
Orlando, FL 32817-4619

Phone

(407) 883-9900

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Nova Southeastern College of Osteo Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1316049539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13031 LEXINGTON SUMMIT ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284309",
            "telephone_number": "407-883-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 CRESCENT BLVD STE 101D",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174619",
            "telephone_number": "407-883-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KENT",
        "middle_name": "G.",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 00547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassey Rae Peterson, RN
• Christina Felicia Peterson, PA-C
• David Brian Peterson, PH.D., HSP
• Dynesha Dorthea Peterson, LAT, ATC
• Jaxon Peterson
• Kimberly K Peterson, OTR/L
• Patricia Ann Peterson
• Shane Stean Peterson, DO
• Ima Petion
• Marie Fabiola Petion

• Mental Health Counselor in Orlando, FL
• Providers in Orlando, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.