AMANDA LEE PETERSON PCC LICDC NPI 1902170996

NPI Information

  • NPI: 1902170996
  • Provider Name: AMANDA LEE PETERSON, PCC, LICDC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 975 KINGSVIEW DR
    LEBANON, OH
    ZIP 45036
  • Phone: (513) 228-7800

Map and Directions

Get Directions

NPI Details

Amanda Lee Peterson, PCC, LICDC is a professional counselor in Lebanon, OH. Amanda Lee Peterson, PCC, LICDC NPI is 1902170996. 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:

975 KINGSVIEW DR
LEBANON, OH
ZIP 45036-562
Phone: (513) 228-7800
Fax: (513) 228-7848

The NPI 1902170996 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 3/8/2012 and was last updated on 5/8/2013.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)ICDC.100327OHIONo
2101YP2500XCounselorProfessionalE.0800170OHIOYes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.