J. Peterson, PH.D., LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

741 Issued in WV

Legal business name

J. PETERSON, PH.D., LLC

Practice address

129 East German St.
Suite 210
Shepherdstown, WV 25443-1650

Phone

(304) 876-3766

Fax

(304) 876-8431

NPI assigned

Jul 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joanne Peterson, PH.D.

Title

Psychologist

Phone

(304) 876-3766

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891992988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1650",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431650",
            "telephone_number": "304-876-3766",
            "fax_number": "304-876-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 EAST GERMAN ST.",
            "address_2": "SUITE 210",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431650",
            "telephone_number": "304-876-3766",
            "fax_number": "304-876-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. PETERSON, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "304-876-3766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9480075000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Shepherdstown, WV
• Providers in Shepherdstown, WV by specialty
• Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.