Active NPI
Jennifer Marie Peters, MA, LMFT
- Marriage & Family Therapist
- Bellevue, WA
National Provider Identifier
1790113504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF60760439
- Practice address
- 16130 SE Eastgate Way Apt D105
Bellevue, WA 98008-5474 - Phone
- (425) 395-4816
- NPI assigned
- Oct 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF60760439 | WA | Primary |
Addresses
Primary practice location
16130 SE Eastgate Way Apt D105
Bellevue, WA 98008-5474
Mailing address
1535 Russell Dr
Streetsboro, OH 44241-8349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LF60760439 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1790113504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1535 RUSSELL DR",
"city": "STREETSBORO",
"state": "OH",
"postal_code": "442418349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16130 SE EASTGATE WAY APT D105",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980085474",
"telephone_number": "425-395-4816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"credential": "MA, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-15",
"last_updated": "2022-01-06",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF60760439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.