Provider Demographics
NPI:1376018499
Name:PETERSON COUNSELING & CONSULTING, INC.
Entity Type:Organization
Organization Name:PETERSON COUNSELING & CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:MARIE CHENOWETH
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-753-8082
Mailing Address - Street 1:8522 CREEDMOOR LN
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4620
Mailing Address - Country:US
Mailing Address - Phone:727-753-8082
Mailing Address - Fax:
Practice Address - Street 1:8522 CREEDMOOR LN
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4620
Practice Address - Country:US
Practice Address - Phone:727-753-8082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health