Mark Linton Petersen, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00004491 Issued in WA

Practice address

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Phone

(360) 734-7310

Fax

(360) 647-8336

NPI assigned

Dec 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• M Linton Petersen Professional name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Mental Health Counselor

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clallam County Public Hospital District No 1Group PAC ID 1557256468, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/forkshospital/r4/

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

• Clallam County Public Hospital District No 1

  dba Forks Community Hospital

  • Critical Access Hospital
  • Forks, WA
  • NPI 1891879680
  Medicare reassignment Care Compare group NPD
• Clallam County Public Hospital District No 1

  dba Forks Family Medical Clinic

  • Rural Health Clinic/Center
  • Forks, WA
  • NPI 1285290338
  NPD
• Clallam County Public Hospital District No 1

  dba Clallam Bay Medical Clinic

  • Rural Health Clinic/Center
  • Clallam Bay, WA
  • NPI 1235213034
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861551293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252914",
            "telephone_number": "360-733-8157",
            "fax_number": "360-647-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-734-7310",
            "fax_number": "360-647-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MARK",
        "middle_name": "LINTON",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00004491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "PETERSEN",
            "middle_name": "LINTON",
            "credential": "MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna Marie Peters, NURSE PRACTITIONER
• Kimberly Ann Peters, PH.D., CCC-A/SLP
• Melissa Peters, MA 60691509
• Sabra Peters, PHARMD
• Cody Petersen, PTA
• Elke Peterson, DPT
• Kyle Peterson
• Marissa Michelle Peterson
• Matthew R Peterson, MD
• Nadya A. Petkova, MA

• Mental Health Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.