Active NPI
Michelle Danielle Peterson, LPC
- Counselor
- Midland Park, NJ
National Provider Identifier
1598117939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 37PC005551000
- Practice address
- 27 Hiawatha CT
Midland Park, NJ 07432-1005 - Phone
- (856) 373-8639
- NPI assigned
- Jul 11, 2016
- Last updated
- Jul 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37PC005551000 | NJ | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00247400 | NJ |
Addresses
Primary practice location
27 Hiawatha CT
Midland Park, NJ 07432-1005
Mailing address
27 Hiawatha CT
Midland Park, NJ 07432-1005
Phone (856) 373-8639
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37PC005551000 | NJ | MD | Counselor |
| 37LC00247400 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bluecrest Detox Inc. | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Flemington, NJ
- NPI 1871487033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1598117939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 HIAWATHA CT",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "074321005",
"telephone_number": "856-373-8639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 HIAWATHA CT",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "074321005",
"telephone_number": "856-373-8639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MICHELLE",
"middle_name": "DANIELLE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NJ",
"license": "37PC005551000",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37LC00247400",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland Park, NJ
- Patrick T Clancy, MD, PA
- Jessica Peacock, L.C.S.W.
- Pediatric Dentistry & Orthodontics, LLC (Pediatric Dentistry of Midland Park)
- Pediatric Dentistry and Orthodontics Center LLC
- Benjamin Daniel Perlman
- Philip M. Schwartz, P.a. (Godwin Dental)
- Cynthia L. Picht, LPC
- Jennifer Picinic, LCADC
- Jessica C Pinelli, LAC
- Pamela Holly Pollack, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.