Active NPI
Andrea Peterson
- Behavior Analyst
- Waite Park, MN
National Provider Identifier
1427762129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA0789
- Practice address
- 314 10TH Ave S Ste 100
Waite Park, MN 56387-1968 - Phone
- (320) 200-1342
- NPI assigned
- Jan 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LBA0789 | MN | Primary |
Addresses
Primary practice location
314 10TH Ave S Ste 100
Waite Park, MN 56387-1968
Mailing address
314 10TH Ave S Ste 100
Waite Park, MN 56387-1968
Phone (612) 767-7222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LBA0789 | MN | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756944000000",
"number": "1427762129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 10TH AVE S STE 100",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871968",
"telephone_number": "612-767-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 10TH AVE S STE 100",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871968",
"telephone_number": "320-200-1342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-09",
"last_updated": "2025-09-04",
"certification_date": "2025-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MN",
"license": "LBA0789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.