Peterson Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1271 Issued in SC

Legal business name

PETERSON PSYCHOLOGICAL SERVICES, LLC

Practice address

125 Alpine Cir
Columbia, SC 29223-6385

Phone

(803) 779-3548

NPI assigned

Mar 15, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Peterson, PH.D.

Title

Clinical Psychologist

Phone

(803) 779-3548

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1982107959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ALPINE CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ALPINE CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236385",
            "telephone_number": "803-779-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "803-779-3548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon K Peters, FNP
• Meredith Peters
• Sahara Peters, DO
• Walter Hamilton Peters IV, M.D.
• Kevin Leon Petersen, PSY.D.
• Arsida Peterson
• Diamond Peterson, RBT
• James Lenford Peterson, PA-C
• Jericha M Peterson, LISW-CP
• Laquista L Peterson, LPC

• Clinical Psychologist in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.