Individual provider Active NPI

Lauren Peterson

  • Counselor
  • East Moline, IL
National Provider Identifier
1568082345
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
4030 4TH Street a
East Moline, IL 61244-3442
Phone
(262) 332-1343
NPI assigned
Apr 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

4030 4TH Street a
East Moline, IL 61244-3442

Mailing address

4030 4TH Street a
East Moline, IL 61244-3442
Phone (262) 332-1343

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

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1568082345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 4TH STREET A",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612443442",
            "telephone_number": "262-332-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 4TH STREET A",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612443442",
            "telephone_number": "262-332-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.