Jennifer Elaine Peterson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-9027 Issued in ID

Practice address

12857 N Andys Gulch Rd
Boise, ID 83714-9423

Phone

(208) 401-4786

NPI assigned

Aug 31, 2022

Last updated

Sep 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 30, 2024 through Jan 30, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Peterson Thrive Therapy

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1730031733
  NPD Authorized official

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1902526833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12857 N ANDYS GULCH RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149423",
            "telephone_number": "208-401-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12857 N ANDYS GULCH RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837149423",
            "telephone_number": "208-401-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENNIFER",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-9027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer@petersonthrivetherapy.com",
            "affiliation": "N",
            "endpointDescription": "business",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12857 N Andys Gulch Rd",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837149423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christian Peterson, MD
• Conner Peterson, PHARMD
• Forrest Read Peterson
• Jamie Brooke Peterson, PA-C
• Janelle Elise Peterson, LCSW
• John Gregory Peterson, DMD
• Kalika Michelle Peterson
• Katelyn Peterson
• Lori Peterson
• Maximilian Graham Peterson

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.