MARK PETERSON NPI 1477043842

NPI Information

  • NPI: 1477043842
  • Provider Name: MARK PETERSON
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 111 GREAT TEAYS BLVD STE 101
    SCOTT DEPOT, WV
    ZIP 25560
  • Phone: (304) 757-8803

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NPI Details

Mark Peterson is a psychiatry psychiatry neurology in Scott Depot, WV with 9 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. Mark Peterson NPI is 1477043842. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

111 GREAT TEAYS BLVD STE 101
SCOTT DEPOT, WV
ZIP 25560-548
Phone: (304) 757-8803
Fax: (304) 757-6904

The NPI 1477043842 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/11/2018 and was last updated on 5/30/2024.

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
12084P0800XPsychiatry & NeurologyPsychiatry30925WEST VIRGINIAYes
22084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry30925WEST VIRGINIANo

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: 11/21/2025

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