Individual provider Active NPI

Daniela F Peterson, LPC

  • Counselor
  • Jackson, WY
National Provider Identifier
1598807760
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632
Phone
(307) 413-6528
NPI assigned
Feb 13, 2007
Last updated
Dec 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X WY Primary

Addresses

Primary practice location

140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632

Mailing address

825 Hi Country Dr
Jackson, WY 83001-9442
Phone (307) 413-6528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010003165 WY Practitioner - Mental Health Counselor 1456775063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Familia Counseling ServicesGroup PAC ID 3375967987, 2 clinicians

Practice addresses (Care Compare)

140 E Broadway Ave
Suite B 13
Jackson, WY 83001-8632
Phone (307) 413-6528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
La Familia Counseling Services CurrentSince Jan 11, 2020 Accepting new patients
La Familia Counseling Services Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1598807760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 HI COUNTRY DR",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830019442",
            "telephone_number": "307-413-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E BROADWAY AVE STE B-13",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018632",
            "telephone_number": "307-413-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANIELA",
        "middle_name": "F",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.