Joel Peterson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

76889 Issued in TX

Practice address

1751 River Run Ste 242
Fort Worth, TX 76107-6645

Phone

(682) 593-9226

NPI assigned

May 21, 2021

Sex

Male

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cowtown Christian Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Worth, TX
  • NPI 1760064067
  NPD Authorized official

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1982279014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5589 RED CARDINAL LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761143620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 RIVER RUN STE 242",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076645",
            "telephone_number": "682-593-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Joyce Peterson, LCSW
• Crystal Peterson
• Desiree Elisabeth Peterson, CPNP-AC
• Fredda Peterson, OT
• Jennifer Elaine Peterson, PT
• Lauren E Peterson, DDS
• Leah Peterson, OTR/L, OTD
• Megan Peterson, DC
• Paula M Peterson, FNP
• Jessica Paige Pethtel, LMSW

• Professional Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.