Active NPI
Jill Marie Peterson
- Professional Counselor
- Minneapolis, MN
National Provider Identifier
1508438235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 204 W Franklin Ave
Minneapolis, MN 55404-2331 - Phone
- (612) 367-4145
- NPI assigned
- Jul 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4095 | MN | |
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
204 W Franklin Ave
Minneapolis, MN 55404-2331
Mailing address
1823 14TH Ave S Apt 2
Minneapolis, MN 55404-2103
Phone (612) 227-1174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1508438235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1823 14TH AVE S APT 2",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042103",
"telephone_number": "612-227-1174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 W FRANKLIN AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042331",
"telephone_number": "612-367-4145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JILL",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-13",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "4095",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.