Active NPI
Dawn M Peterson
- Mental Health Counselor
- Hoquiam, WA
National Provider Identifier
1699244111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 615 8TH St
Hoquiam, WA 98550 - Phone
- (360) 532-4357
- Fax
- (360) 577-0269
- NPI assigned
- Nov 14, 2018
- Last updated
- Nov 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | WA | Primary | |
| Peer Specialist | 175T00000X | WA |
Addresses
Primary practice location
615 8TH St
Hoquiam, WA 98550
Mailing address
PO Box 1847
Longview, WA 98632-8140
Phone (360) 353-9828
Other practice location 1
615 8th St
Hoquiam, WA 98550
Phone (360) 532-4357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2113068 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Wellness | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Longview, WA
- NPI 1487659579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1699244111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1847",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986328140",
"telephone_number": "360-353-9828",
"fax_number": "360-577-0269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 8TH ST",
"city": "HOQUIAM",
"state": "WA",
"postal_code": "98550",
"telephone_number": "360-532-4357",
"fax_number": "360-577-0269"
}
],
"practiceLocations": [
{
"address_1": "615 8th St",
"address_purpose": "LOCATION",
"city": "Hoquiam",
"state": "WA",
"postal_code": "98550",
"country_code": "US",
"telephone_number": "360-532-4357",
"fax_number": "360-577-0269",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "DAWN",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": null,
"primary": true
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WA",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2113068",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hoquiam, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.