Nicole Petersen Well-Being LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

NICOLE PETERSEN WELL-BEING LLC

Practice address

3815 Bryant Ave S Apt 6
Minneapolis, MN 55409-1061

Phone

(612) 559-9964

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Nicole Petersen, LPCCNPI 1063247237

Title

Managing Member

Phone

(612) 559-9964

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.

• Nicole Petersen, MA, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1063247237
  NPD Authorized official

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1730905571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 TERRITORY PASS",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446118",
            "telephone_number": "612-559-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 BRYANT AVE S APT 6",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091061",
            "telephone_number": "612-559-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE PETERSEN WELL-BEING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "612-559-9964",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sondra Nickolson, R.D.H., M.E.D.
• Aurora Gwynimue Nicneven
• Emily Jo Nicol, CPNP-PC
• Sue Nicol, LPN, PHD
• Nicole J Wolf PHD LP
• Narysse Nicolet, MD
• Nicollet 38TH St Dental
• Nicollet Avenue Dental, PLLC
• Nicollet Chiropractic Center
• Nicollet Dental

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.