Michelle C Peterson, MS LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1315 Issued in MN

Practice address

7600 Parklawn Ave
Edina, MN 55435

Phone

(612) 203-2961

Fax

(952) 831-0033

NPI assigned

Apr 8, 2006

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MN Mental Health Consulting LLC

  • Community/Behavioral Health Agency
  • Edina, MN
  • NPI 1639343783
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851354153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 PARKLAWN AVENUE,",
            "address_2": "380",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354300",
            "telephone_number": "612-203-2961",
            "fax_number": "952-831-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 PARKLAWN AVE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "612-203-2961",
            "fax_number": "952-831-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 France Ave S",
            "address_2": "329",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554354300",
            "country_code": "US",
            "telephone_number": "612-203-2961",
            "fax_number": "952-831-0033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "credential": "MS LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "990991045225",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1639343783",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "918142300",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918142300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Rose Peterson, PA-C
• Kate S Peterson, ATC
• Kelly L. Peterson, OTR/L
• Krista Peterson, PSY.D.L.P.
• Matthew Christian Peterson, DPM
• Randolph K. Peterson, M.D.
• Robert K Peterson, DDS
• Rodney Holmes Peterson, M.D.
• Stephen Wayne Peterson, LPCC
• Tara Peterson, LICSW, LADC

• Marriage & Family Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.