Ashley Marie Petersen, PSY.D.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

32 Main St Ste D
Park Ridge, IL 60068-4060

Phone

(847) 823-4444

NPI assigned

Jul 16, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 27, 2023 through Jun 27, 2027

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.

• Jennifer E. Manfre, LTD

  • Clinical Psychologist
  • Woodridge, IL
  • NPI 1447793591

  Multi-Specialty

  NPD (past)
• Michael J. Athans, PH.D. and Associates, LTD.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1235100140

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1326202516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 W 10TH ST",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945091653",
            "telephone_number": "925-777-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 MAIN ST STE D",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684060",
            "telephone_number": "847-823-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Pesok, MD
• Alexander Peters
• Barbara K Peters, MD
• David S Peters, MD
• Dominique Alyssa Peters, MD
• Ella Margaret Petersen, LCSW
• Courtney Lee Peterson, LCSW
• Robert Michael Peterson Jr., D.D.S., M.S
• Ross D Peterson
• Mila Petkovic, O.D.

• Behavior Analyst in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.