LISA A PETERSON LMHC LCDP LCDCS MAC NPI 1962514869

NPI Information

NPI: 1962514869
Provider Name: LISA A PETERSON, LMHC LCDP LCDCS MAC
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Individual
PECOS Registration: Yes
Address: 110 ELMWOOD AVE
PROVIDENCE, RI
ZIP 02907
Phone: (401) 432-6029

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NPI Details

Lisa A Peterson, LMHC LCDP LCDCS MAC is a mental health counselor in Providence, RI. Lisa A Peterson, LMHC LCDP LCDCS MAC NPI is 1962514869. 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:

110 ELMWOOD AVE
PROVIDENCE, RI
ZIP 02907-423
Phone: (401) 432-6029
Fax: (401) 300-5656

The NPI 1962514869 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.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 6/10/2025.

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	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	LCDP00129	RHODE ISLAND	No
2	101YM0800X	Counselor	Mental Health	MHC00235	RHODE ISLAND	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	412210	OTHER	RHODE ISLAND	BLUE CHIP
2	29290 8	OTHER	RHODE ISLAND	BLUE CROSS
3	LJ55332	MEDICAID	RHODE ISLAND

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

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