Jessica Blair Peters, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401018211 Issued in MI

Practice address

41800 W 11 Mile Rd Ste 110
Novi, MI 48375-1818

Phone

(947) 219-1283

NPI assigned

Dec 19, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emh A2 CD, LLCGroup PAC ID 7719357086, 5 clinicians

Ellie Mental Health Live Authentic PLLCGroup PAC ID 0648644658, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Ellie Mental Health Live Authentic PLLC

  • Counseling Psychologist
  • Novi, MI
  • NPI 1760193031
  Medicare reassignment Care Compare group NPD
• Emh A2 CD, LLC

  • Mental Health Counselor
  • Ann Arbor, MI
  • NPI 1164166153
  Medicare reassignment Care Compare group NPD
• Emh Birmingham-Bloomfield-Troy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomfield Hills, MI
  • NPI 1467163881
  Medicare reassignment NPD
• Cozy Couch Counseling L3C

  • Mental Health Counselor
  • Bloomfield Hills, MI
  • NPI 1164381109
  NPD Authorized official
• Giesken Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarkston, MI
  • NPI 1336668565
  NPD (past)

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1508338229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 110",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "947-219-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 110",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "947-219-1283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36400 Woodward Ave Ste 222",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483040913",
            "country_code": "US",
            "telephone_number": "248-629-2799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6960 Orchard Lake Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483224519",
            "country_code": "US",
            "telephone_number": "248-985-9942",
            "fax_number": "248-221-1775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JESSICA",
        "middle_name": "BLAIR",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016415",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Marie Pesola, PA-C
• Rachael Peterlein
• Sarah Petermichel
• Brooke Peters
• Dollar Peters
• Grace Petersen
• Kayli Peterson-Johnston
• Robert G Peterson, DC
• Tiyanna Peterson
• Madison Pethick

• Professional Counselor in Novi, MI
• Providers in Novi, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.