Holly Petersen

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

085016 Issued in NY

Practice address

1143 47TH Ave
Long Island City, NY 11101-5465

Phone

(631) 880-0644

NPI assigned

Feb 5, 2014

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1760806103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 36TH ST",
            "address_2": "APT 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111061001",
            "telephone_number": "631-880-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 47TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015465",
            "telephone_number": "631-880-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "085016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Persaud, OTR/L
• Kaloutie Persaud, RN
• Personal Touch Home Care of New York, Inc
• Nazish Pervez, RD, CDN
• Santiago Petalver, BSN, RN, MBA
• John Phair, MD
• Minh Tam Pham, PA-C
• Neethu Philips
• Erica G. Phillips, MD, MS
• Phoenix House Foundation

• Marriage & Family Therapist in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.