Johnathon Dahlin Peterson, LCMHC, LPC in South Jordan, UT

Johnathon Dahlin Peterson, LCMHC, LPC is a medicare enrolled "Counselor - Mental Health" provider in South Jordan, Utah. His current practice location is 1268 W South Jordan Pkwy Ste 300, South Jordan, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 515-5850.

Johnathon Dahlin Peterson is licensed to practice in Utah (license number 11125479-6004) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487381869.

Contact Information

	Johnathon Dahlin Peterson, LCMHC, LPC
	1268 W South Jordan Pkwy Ste 300, South Jordan, UT 84095-4653
	(801) 515-5850
	(801) 254-9755

Map and Direction

Healthcare Provider's Profile

Full Name	Johnathon Dahlin Peterson
Gender	Male
Speciality	Counselor - Mental Health
Location	1268 W South Jordan Pkwy Ste 300, South Jordan, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487381869
Provider Enumeration Date: 08/04/2022
Last Update Date: 09/25/2024

Medicare PECOS Information:

PECOS PAC ID: 9032652409
Enrollment ID: I20240613004593

Medical Identifiers

Medical identifiers for Johnathon Dahlin Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487381869	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	95059 (Texas)	Secondary
101YM0800X	Counselor - Mental Health	11125479-6004 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Johnathon Dahlin Peterson allows following entities to bill medicare on his behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220525002138

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnathon Dahlin Peterson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Johnathon Dahlin Peterson, LCMHC, LPC Po Box 95868, South Jordan, UT 84095-0868 Ph: (801) 515-5850	Johnathon Dahlin Peterson, LCMHC, LPC 1268 W South Jordan Pkwy Ste 300, South Jordan, UT 84095-4653 Ph: (801) 515-5850

Reviews and Comments

Counselor in South Jordan, UT

Patricia Hayner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10298 S Otter Trail Dr, South Jordan, UT 84009 Phone: 951-541-3043
Stephanie Church Kelley, ACMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1108 W South Jordan Pkwy Ste B, South Jordan, UT 84095 Phone: 385-215-9084
Caitlin Lilah Rollins, Counselor Medicare: Medicare Enrolled Practice Location: 1108 W South Jordan Pkwy Ste B, South Jordan, UT 84095 Phone: 385-215-9084
Jennifer Hong, ACMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1108 W South Jordan Pkwy Ste B, South Jordan, UT 84095 Phone: 385-215-9084
Eric Bylund, Counselor Medicare: Medicare Enrolled Practice Location: 11260 S River Heights Dr., South Jordan, UT 84095 Phone: 801-298-2000
Virginia Carolyn Williams Anderson, ACMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1108 W South Jordan Pkwy Ste B, South Jordan, UT 84095 Phone: 385-215-9084
Trudy Bond, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1258 W South Jordan Pkwy, South Jordan, UT 84095 Phone: 801-599-8954

Johnathon Dahlin Peterson, LCMHC, LPC - Medicare Counselor in South Jordan, UT