Roxanne S Peterson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH Issued in WA

Practice address

615 Short St
Steilacoom, WA 98388-3115

Phone

(253) 221-6789

Fax

(253) 584-8046

NPI assigned

Feb 1, 2010

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Mental Health Counselor

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1659603686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHORT ST",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983883115",
            "telephone_number": "253-221-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHORT ST",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983883115",
            "telephone_number": "253-221-6789",
            "fax_number": "253-584-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ROXANNE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00063729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LH60088357",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN00063729",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Reid Miller, DDS
• Joseph Michael Mitrovich, PSY.D.
• Sheryl Lynn Morelli, LMP
• Pacific Northwest Neurology PLLC
• Iona May Parker, APRN-BC
• Jordan Patrick Sanders, LMHC; LPC-MHSP
• Sea Spa Steilacoom
• Sea Spa Steilacoom
• Forozan Shokrollahi
• Sandra Ruth Shovlain, RN

• Mental Health Counselor in Steilacoom, WA
• Providers in Steilacoom, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.