Tia Peterson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L7989 Issued in OR

Practice address

655 N 3Rd St
Central Point, OR 97502-1876

Phone

(541) 494-6323

Fax

(541) 494-6381

NPI assigned

Oct 13, 2015

Last updated

Jan 10, 2025By the provider in NPPES

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

Other names 1

• Tia Khachitphet Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• La Clinica del Valle Family Health Care Center Inc.

  dba La Clinica School-Based Health Center at Crater High School

  • Federally Qualified Health Center (FQHC)
  • Central Point, OR
  • NPI 1205198470
  NPD (past)

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1972974293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N 3RD ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975021876",
            "telephone_number": "541-494-6323",
            "fax_number": "541-494-6381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 S Ivy St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975013517",
            "country_code": "US",
            "telephone_number": "541-261-4633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L7989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIA",
            "last_name": "KHACHITPHET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Perfectly Loved Midwifery, LLC
• Patrick Peters, MSW
• Elizabeth Jean Peterson, LPC, CADC I
• Karsten Peterson
• Kristin Kay Peterson, PHYSICAL THERAPIST
• Sarah Pfaff, LMT
• Maureen Pheley, RN
• Phlebotomy Services International Inc.
• Heather Pleasant
• Margaret B Plein, MS, LPC

• Mental Health Counselor in Central Point, OR
• Providers in Central Point, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.