AMANDA LEE PETERSON PCC LICDC NPI 1902170996

NPI Information

NPI: 1902170996
Provider Name: AMANDA LEE PETERSON, PCC, LICDC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
975 KINGSVIEW DR
LEBANON, OH
ZIP 45036
Phone: (513) 228-7800
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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 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
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	ICDC.100327	OHIO	No
2	101YP2500X	Counselor	Professional	E.0800170	OHIO	Yes

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: 11/14/2023

NPI Synchronization or Removal

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