Peter John Vandersteen, MA, LMHC, LCPC, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-9428 Issued in ID

Practice address

403 Ponderosa CT Apt 101
Moscow, ID 83843-3453

Phone

(208) 717-1130

NPI assigned

Oct 10, 2014

Last updated

Jan 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1699179242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PONDEROSA CT APT 101",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433453",
            "telephone_number": "208-717-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PONDEROSA CT APT 101",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838433453",
            "telephone_number": "208-717-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERSTEEN",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "credential": "MA, LMHC, LCPC, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "CADC-5045",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60898613",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-9428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin R Tu, BA
• University of Idaho (CDHD/Idaho Assistive Technology Project)
• University of Idaho (CDHD Behavioral Consultants)
• Ryan Tobias Van Amerongen, MA, ATC, LAT
• Aaron James Vandenbos, M.D.
• Ashmel Vargas
• Veritas Medical Group LLC (Veritas Surgery)
• Astrid Villa
• Nora Vogt
• Tyler Hempfling Volkmann

• Mental Health Counselor in Moscow, ID
• Providers in Moscow, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.