Leandra La Rue Petterson, MS, CADC-I, DVTPP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

07423-I Issued in NV

Practice address

7 S Water St Ste 1
Henderson, NV 89015-7213

Phone

(702) 568-5971

NPI assigned

Dec 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1710795653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 WILD AMBROSIA AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890742891",
            "telephone_number": "602-635-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S WATER ST STE 1",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157213",
            "telephone_number": "702-568-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "LEANDRA",
        "middle_name": "LA RUE",
        "name_prefix": "Mrs.",
        "credential": "MS, CADC-I, DVTPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "07423-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Kent Peterson, O.D.
• Sarah E Peterson, ATC
• Sarah Marie Peterson
• Velvet Petkov
• Jon S Petrick, DC
• Leairia Pettway
• Amanda Petty, PT, DPT, NCS
• Gillie Ann Petty
• Summer Ann Pfarr, CADC, BS
• Lyndsay Marie Pfeiffer, CABI

• Addiction (Substance Use Disorder) Counselor in Henderson, NV
• Providers in Henderson, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.