Active NPI
Stephanie Peterson
- Professional Counselor
- West Haven, CT
National Provider Identifier
1457701153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2974
- Practice address
- 415 Main St
West Haven, CT 06516-4296 - Phone
- (203) 931-1184
- Fax
- (203) 931-0067
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2974 | CT | Primary |
Addresses
Primary practice location
415 Main St
West Haven, CT 06516-4296
Mailing address
262 Candlewood Hill Rd
Higganum, CT 06441-4254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206003212 | CT | Order and Referring Only - Mental Health Counselor | 9739522889 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- stephanie.peterson@chcict.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1457701153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 CANDLEWOOD HILL RD",
"city": "HIGGANUM",
"state": "CT",
"postal_code": "064414254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 MAIN ST",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065164296",
"telephone_number": "203-931-1184",
"fax_number": "203-931-0067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "2974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.