KELLY PETERSON NPI 1366923963

NPI Information

NPI: 1366923963
Provider Name: KELLY PETERSON
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
205 BURLINGTON RD
BEDFORD, MA
ZIP 01730
Phone: (781) 862-3600
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Kelly Peterson is a mental health counselor in Bedford, MA. Kelly Peterson NPI is 1366923963. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

205 BURLINGTON RD
BEDFORD, MA
ZIP 01730-406
Phone: (781) 862-3600

The enumeration date for this NPI number is 8/22/2018 and was last updated on 8/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	99618201	OTHER	MASSACHUSETTS	NETWORK HEALTH
2	0000023532	OTHER	MASSACHUSETTS	BMC
3	1004745	OTHER	MASSACHUSETTS	FALLON
4	042611055	OTHER	MASSACHUSETTS	TAX ID
5	1303287	OTHER	MASSACHUSETTS	MBHP
6	1004745	OTHER	MASSACHUSETTS	NHP
7	M18633	OTHER	MASSACHUSETTS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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