NPIMap

Organization Active NPI

Carl V. Peterson, PH.D., LLC

  • Adult Mental Health Clinic/Center
  • Eugene, OR
National Provider Identifier
1659615938
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
386 Issued in OR
Legal business name
CARL V. PETERSON, PH.D., LLC
Practice address
286 E 18TH Ave
Eugene, OR 97401-4159
Phone
(541) 343-5501
Fax
(541) 484-0416
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Dr. Carl V. Peterson, PH.D.NPI 1568533602
Title
Licensed Psychologist
Phone
(541) 343-5501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 386 OR Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 386 OR

Addresses

Primary practice location

286 E 18TH Ave
Eugene, OR 97401-4159

Mailing address

286 E 18TH Ave
Eugene, OR 97401-4159
Phone (541) 343-5501

Other names 1

  • Carl V. Peterson, Ph.D. Doing business as

National Provider Directory

National Provider Directory

Locations

286 E 18th Ave
Eugene, OR 97401
Phone (541) 343-5501

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1659615938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014159",
            "telephone_number": "541-343-5501",
            "fax_number": "541-484-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 E 18TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014159",
            "telephone_number": "541-343-5501",
            "fax_number": "541-484-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL V. PETERSON, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "541-343-5501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": "386",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OR",
            "license": "386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carl V. Peterson, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.