Mona Juanita Peterson-Omotola, PH.D. LCPC-AC

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

7400 Beaufont Springs Drive Suite 300
Richmond,, VA 23225

Phone

(866) 720-5321

NPI assigned

Oct 24, 2016

Last updated

Jan 7, 2020By the provider in NPPES

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

Other names 1

• Mona Juanita Jones Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Faith Christian Ministry Non-Denominational Church Inc.

  • Preferred Provider Organization
  • Richmond, VA
  • NPI 1780127589
  NPD (past) Authorized official

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1477004695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7306 SUMMERTREE DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232345935",
            "telephone_number": "866-720-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 BEAUFONT SPRINGS DRIVE SUITE 300",
            "city": "RICHMOND,",
            "state": "VA",
            "postal_code": "23225",
            "telephone_number": "866-720-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON-OMOTOLA",
        "first_name": "MONA",
        "middle_name": "JUANITA",
        "name_prefix": "Dr.",
        "credential": "PH.D. LCPC-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "NCCA14946",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "JONES",
            "middle_name": "JUANITA",
            "credential": "PH.D.,LCPC-AC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lynne Peters, PHARMD
• Jesse Silliman Peters
• Lester G Peters, O.D.
• Brittni Ashlan Petersen, LCSW
• Kirklen Elaine Petersen, MD
• Amity Peterson, DO, PH.D.
• Andrew G Peterson
• Blake Richard Peterson
• Cortney Helen Peterson, FNP-C
• Leslie Ellen Peterson, FNP-C

• Pastoral Counselor in Richmond, VA
• Providers in Richmond, VA by specialty
• Pastoral Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.