Lisa Peterson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166001244 Issued in IL

Practice address

1770 W Berteau Ave Ste 304
Chicago, IL 60613-6131

Phone

(312) 278-3771

NPI assigned

Aug 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 31, 2024 through May 31, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Leap Therapy Chicago, PLLC

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1730861337

  Marriage & Family Therapist

  NPD Authorized official

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1528467503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 W BERTEAU AVE STE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136131",
            "telephone_number": "312-278-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 W BERTEAU AVE STE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136131",
            "telephone_number": "312-278-3771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "661 W Lake St Ste 2S",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606611034",
            "country_code": "US",
            "telephone_number": "312-278-3771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5205 N Christiana Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606254724",
            "country_code": "US",
            "telephone_number": "847-784-8814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LISA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Peterson, AGPCNP-BC
• Kelly A Peterson
• Kristin Peterson, M.D.
• Kristin Peterson, SLP
• Kyle S Peterson, RN
• Loann Peterson, MD
• Mara Berenice Peterson, RN
• Mary-Margaret Peterson, LSW
• Molly Peterson, PT, DPT
• Paloma Carolina Peterson, LCSW

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.