Lindsey Petersen Llc | |
3376 Ridge Gap Rd Columbus OH 43221-1967 | |
(614) 210-3654 | |
(614) 974-2765 |
Full Name | Lindsey Petersen Llc |
---|---|
Speciality | Counselor |
Location | 3376 Ridge Gap Rd, Columbus, Ohio |
Authorized Official Name and Position | Lindsey Petersen (COUNSELOR) |
Authorized Official Contact | 6147963054 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lindsey Petersen Llc 3376 Ridge Gap Rd Columbus OH 43221-1967 Ph: (614) 210-3654 | Lindsey Petersen Llc 3376 Ridge Gap Rd Columbus OH 43221-1967 Ph: (614) 210-3654 |
NPI Number | 1225612815 |
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Provider Enumeration Date | 05/10/2021 |
Last Update Date | 11/15/2022 |
Certification Date | 11/15/2022 |
Medicare PECOS PAC ID | 0648612978 |
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Medicare Enrollment ID | O20240531000997 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225612815 | NPI | - | NPPES |
0248617 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Lindsey Petersen |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1376914622 PECOS PAC ID: 6709227846 Enrollment ID: I20240531001145 |
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