Life Transformations

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

LIFE TRANSFORMATIONS

Practice address

227 6TH St N
Breckenridge, MN 56520-1503

Phone

(701) 640-8915

NPI assigned

Oct 31, 2017

Organization subpart

No

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

Authorized official

Name

Mata Peteson

Title

Owner/Addiction Counselor

Phone

(701) 640-8915

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mata Marie Peterson, LSW, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Breckenridge, MN
  • NPI 1710320890
  NPD

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1689186587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565380703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 6TH ST N",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201503",
            "telephone_number": "701-640-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TRANSFORMATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "PETESON",
        "authorized_official_first_name": "MATA",
        "authorized_official_title_or_position": "OWNER/ADDICTION COUNSELOR",
        "authorized_official_telephone_number": "701-640-8915"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Krauth, APRN,CNP, DNP
• Jessica Lynn Kurth
• Kaylen Kvidt, PT, DPT, ATC
• Sarah Lansing, DPT
• Mark Laraway, DPT
• Vartan Malkasian, M.D.
• Kallie Marsh
• Jon David McDonald, D.C.
• Amy McIntosh
• Sophie Louise Meier, DPT

• Addiction (Substance Use Disorder) Counselor in Breckenridge, MN
• Providers in Breckenridge, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.