Active NPI
Courtney M Petersen
- Assistant Behavior Analyst
- Omaha, NE
National Provider Identifier
1891244018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- 0016
- Practice address
- 5321 S 138TH St
Omaha, NE 68137-2913 - Phone
- (402) 895-4000
- NPI assigned
- Sep 28, 2016
- 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 |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 0016 | NE | Primary |
Addresses
Primary practice location
5321 S 138TH St
Omaha, NE 68137-2913
Mailing address
5321 S 138TH St
Omaha, NE 68137-2913
Phone (402) 895-4000
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 |
|---|---|---|---|
| 0016 | NE | MD | Assistant Behavior Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childhood Autism Services Inc | Assistant Behavior Analyst | 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.
-
- Community/Behavioral Health Agency
- La Vista, NE
- NPI 1730473117
Assistant Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1891244018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5321 S 138TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372913",
"telephone_number": "402-895-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5321 S 138TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681372913",
"telephone_number": "402-895-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "COURTNEY",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "NE",
"license": "0016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.