Active NPI
Rebecca Peterson
- Mental Health Counselor
- Des Moines, IA
National Provider Identifier
1669856373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 077223
- Practice address
- 925 Porter Ave
Des Moines, IA 50315-7235 - Phone
- (515) 285-6781
- NPI assigned
- Jul 13, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 077223 | IA | Primary |
Addresses
Primary practice location
925 Porter Ave
Des Moines, IA 50315-7235
Mailing address
925 Porter Ave
Des Moines, IA 50315-7235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077223 | IA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orchard Place | Past | 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 and National Provider Directory roles.
-
- Psychiatric Residential Treatment Facility
- Des Moines, IA
- NPI 1245220938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1669856373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 PORTER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503157235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 PORTER AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503157235",
"telephone_number": "515-285-6781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "REBECCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "077223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.