NPIMap

Individual provider Active NPI

Amy Peterburs, MSAT, LPC-IT

  • Mental Health Counselor
  • Mequon, WI
National Provider Identifier
1851624191
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10922 N Cedarburg Rd
Mequon, WI 53092-4304
Phone
(262) 242-3810
Fax
(262) 242-3816
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10922 N Cedarburg Rd
Mequon, WI 53092-4304

Mailing address

10922 N Cedarburg Rd
Mequon, WI 53092-4304
Phone (262) 242-3810

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Community Mental Health Counseling Centers, Inc Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1851624191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10922 N CEDARBURG RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924304",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10922 N CEDARBURG RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924304",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERBURS",
        "first_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "MSAT, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.