Theadora Ruth Peterson, LADC-1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

22506 Issued in MA

Practice address

8 Harris St
Newburyport, MA 01950-2635

Phone

(617) 447-4043

NPI assigned

Nov 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1427325265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MEETING HOUSE HILL RD",
            "city": "WEST NEWBURY",
            "state": "MA",
            "postal_code": "019851509",
            "telephone_number": "617-447-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 HARRIS ST",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019502635",
            "telephone_number": "617-447-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THEADORA",
        "middle_name": "RUTH",
        "name_prefix": "Miss",
        "credential": "LADC-1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "22506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Care Physicians, PC
• Elizabeth Ann Pescosolido
• Peter a. Hartmann MD PC
• Peter Williams, PHD
• Paulette Ruth Peterson, LMHC, LMFT
• Arielle Petti, FNP-C
• Marjorie Pettingell
• Nicole Alise Peura, OTR
• Marjorie Ann Pierce, LICSW
• Meagan Emily Pietrasiak, NP

• Addiction (Substance Use Disorder) Counselor in Newburyport, MA
• Providers in Newburyport, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.