Judith Irene Pederson, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1022 Issued in MN

Practice address

430 S Andrew Dr NE
New London, MN 56273

Phone

(320) 354-2152

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932282787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S ANDREW DR NE",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562739579",
            "telephone_number": "320-354-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S ANDREW DR NE",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "320-354-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "JUDITH",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living Services Foundation/New London, LLC
• Karyn Loos, OTR/L
• Cassandra Lee Meis
• New London Family Dental
• Opco New London, MN, LLC
• Kathryn L Pederson
• Terry M Peterson, MD
• Laura Prince
• Pamela Jo Reinertson, PT
• Bridget Jae Reuss, OTR

• Marriage & Family Therapist in New London, MN
• Providers in New London, MN by specialty
• Marriage & Family Therapist in Minnesota

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.