Individual provider Active NPI

Maureen H Peterson, LMHC

  • Mental Health Counselor
  • University Place, WA
National Provider Identifier
1609905785
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00005080 Issued in WA
Practice address
2701 Sylvan Dr W
University Place, WA 98466-2740
Phone
(253) 273-9655
NPI assigned
Mar 5, 2007
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X LH00005080 WA Primary

Addresses

Primary practice location

2701 Sylvan Dr W
University Place, WA 98466-2740

Mailing address

2701 Sylvan Dr W
University Place, WA 98466-2740
Phone (253) 273-9655

Other identifiers 1

IdentifierTypeStateIssuer
910598103OtherWATAX IDENTIFCATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH00005080WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hopesparks Mental Health Past Accepting new patients
Professional Resource Network 365 PLLC Mental Health Past 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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1609905785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 SYLVAN DR W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662740",
            "telephone_number": "253-273-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 SYLVAN DR W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662740",
            "telephone_number": "253-273-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MAUREEN",
        "middle_name": "H",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00005080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFCATION NUMBER",
            "identifier": "910598103",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

Verify at the official NPI Registry.