Active NPI
Karen Peterson, LMFT
- Marriage & Family Therapist
- Wayzata, MN
National Provider Identifier
1467702225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2296
- Practice address
- 18080 Berry LN
Wayzata, MN 55391-3202 - Phone
- (612) 201-4570
- NPI assigned
- Sep 19, 2012
- Last updated
- Jul 16, 2014
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2296 | MN | Primary |
Addresses
Primary practice location
18080 Berry LN
Wayzata, MN 55391-3202
Mailing address
1804 W 50TH St
Minneapolis, MN 55419-1001
Phone (612) 201-4570
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 |
|---|---|---|---|
| 2296 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1467702225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 W 50TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554191001",
"telephone_number": "612-201-4570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18080 BERRY LN",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553913202",
"telephone_number": "612-201-4570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "KAREN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "2296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayzata, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.