Earth&Light, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EARTH&LIGHT, LLC

Practice address

8031 Williston Rd Ste 9
Williston, VT 05495-6200

Phone

(802) 858-5290

NPI assigned

Feb 29, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Petersen, LCMHCNPI 1942704127

Title

Owner

Phone

(180) 287-1082

Specialties & licenses 1

Addresses

Other names 1

• Lisa Marie Mallory Petersen Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Petersen, LCMHC

  • Mental Health Counselor
  • Burlington, VT
  • NPI 1942704127
  NPD Authorized official

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1962269696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8031 WILLISTON RD STE 9",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054956200",
            "telephone_number": "802-858-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 WILLISTON RD STE 9",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054956200",
            "telephone_number": "802-858-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH&LIGHT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "180-287-1082",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisa Marie Mallory Petersen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine C Ducasse
• Susan Dumais, BCBA
• Denise M Durant, M.D.
• Corey James Duteau, R.PH
• Charles Scott Earisman, MA
• Jake Camron Edwards, BCBA
• Eleanor Health Professional
• Joellen Emerson, BCABA
• Erin K. Hall, MD PLLC
• M Jacklynn Estes, RPH

• Community/Behavioral Health Agency in Williston, VT
• Providers in Williston, VT by specialty
• Community/Behavioral Health Agency in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.