Provider Demographics
NPI:1265773378
Name:PETERFESO, ABBY L (LPCC, LPC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:L
Last Name:PETERFESO
Suffix:
Gender:F
Credentials:LPCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 WAYZATA BLVD STE 700-4029
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:612-842-1515
Mailing Address - Fax:612-457-1547
Practice Address - Street 1:750 2ND ST NE STE 218
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8124
Practice Address - Country:US
Practice Address - Phone:612-842-1515
Practice Address - Fax:612-457-1547
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0588101YP2500X
COLPC-6045101YP2500X
MNLPCC1564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional