Kerry Peterson, M.A., CCC/SLP, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6625 Daly Rd
West Bloomfield, MI 48322-3410

Phone

(248) 737-3430

Fax

(248) 737-3433

NPI assigned

May 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Kaufman Children's Center

  • Behavior Analyst
  • West Bloomfield, MI
  • NPI 1366877318
  NPD (past)

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1720371933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 BOULDER POND DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088624",
            "telephone_number": "248-737-3430",
            "fax_number": "248-737-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430",
            "fax_number": "248-737-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KERRY",
        "credential": "M.A., CCC/SLP, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Ann Petchell, PA-C
• Ronnya Peter, BSN
• Alissa Kristine Peters, PT, DPT, NCS, CBIS
• Jessica Kaur Peters, NP
• Traci Leigh Peters, CRNA
• Thomas J Petinga, D.O.
• Molly Anne Snyder Petreanu, M.S., CCC-SLP
• Debra Peven, DO
• Jennifer Marie Pfeiffer, PHYSICIAN ASSISTANT
• Josef Philipp, DC

• Behavior Analyst in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.