Marissa Leigh Peterson, M.S., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2007017523 Issued in MO

Practice address

1905 Stadium Blvd
Jefferson City, MO 65109

Phone

(888) 403-1071

NPI assigned

Feb 6, 2007

Last updated

Jun 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa Cirincione Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1417096587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARISSA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "M.S., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2007017523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CIRINCIONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Peters
• Jessica Peters
• Stephanie Petersen
• Cole Ryan Petershagen, PHARM.D.
• Danny Keith Peterson, DC
• Theresa C Phillips, MSN APRN, BC
• Phoenix Home Care, LLC (Phoenix Home Care)
• Phoenix Home Care, LLC (Phoenix Home Care & Hospice)
• Physicians Imaging, LLC
• Physicians Optical Service Inc

• Professional Counselor in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.