Active NPI
Angela Peterson, LPC
- Professional Counselor
- Amarillo, TX
National Provider Identifier
1801432380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 20208
- Practice address
- 1901 Medi Park Dr Ste 216
Amarillo, TX 79106-2110 - Phone
- (806) 552-9700
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | 20208 | TX | Primary |
Addresses
Primary practice location
1901 Medi Park Dr Ste 216
Amarillo, TX 79106-2110
Mailing address
PO Box 50026
Amarillo, TX 79159-0026
Phone (806) 552-9700
Other practice location 1
1250 Wallace Blvd
Amarillo, TX 79106-1741
Phone (806) 353-3596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 416078001 | Medicaid | TX | |
| 77385 | Other | TX | TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20208 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1801432380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50026",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791590026",
"telephone_number": "806-552-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR STE 216",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062110",
"telephone_number": "806-552-9700"
}
],
"practiceLocations": [
{
"address_1": "1250 Wallace Blvd",
"address_purpose": "LOCATION",
"city": "Amarillo",
"state": "TX",
"postal_code": "791061741",
"country_code": "US",
"telephone_number": "806-353-3596",
"fax_number": "806-353-4927",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "ANGELA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "20208",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "416078001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
"identifier": "77385",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.