Kathleen M Peterson, MED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00005488 Issued in WA

Practice address

3311 W Clearwater Ave Ste D111
Kennewick, WA 99336-2696

Phone

(509) 737-9660

Fax

(509) 737-9610

NPI assigned

Sep 15, 2006

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

Other names 1

• Kathleen Stangeland Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1467558841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 W CLEARWATER AVE STE D111",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362696",
            "telephone_number": "509-737-9660",
            "fax_number": "509-737-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 W CLEARWATER AVE STE D111",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362696",
            "telephone_number": "509-737-9660",
            "fax_number": "509-737-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "00005488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "STANGELAND",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda D Petersen, PA-C
• Daniel Allen Petersen, DDS
• Jared M. Petersen, DO
• Peterson Medical LLC
• Kathleen Peterson, PHARMD
• Rebecca Marie Peterson, RN
• Andrea Christine Peyton, RC
• Kelly Katherine Pflieger, CCC-SLP
• Suresh Philip, MD
• Elizabeth Phillips

• Mental Health Counselor in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.