Lindsay Mashae Petersen, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

12087835-8900 Issued in UT

Practice address

519 W State Rd Ste 103
Pleasant Grove, UT 84062-2158

Phone

(801) 477-4368

NPI assigned

Oct 16, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1568282168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2096 E EMERALD AVE",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055368",
            "telephone_number": "435-730-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W STATE RD STE 103",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622158",
            "telephone_number": "801-477-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LINDSAY",
        "middle_name": "MASHAE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "12087835-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "12087835-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Pearson
• Irene Peregrin Alvarez, MD
• Peregrine Mental Health
• Kaylin Perez
• Farrah Dawn Petersen, CMHC
• Cassandra Peterson
• Janae Peterson, ACMHC
• Rebekah Kay Peterson, LCSW
• Sophia Christina Pickering
• Heather Rene Pickett, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.