Mr Kevin Leon Petersen, PSYD - Psychologist in Columbia, SC

Mr Kevin Leon Petersen, PSYD is a Psychologist based in Columbia, South Carolina. Mr Kevin Leon Petersen is licensed to practice in * (Not Available) (license number ) and his current practice location is 6439 Garners Ferry Road, Wjbd Va Medical Center, Columbia, South Carolina. He can be reached at his office (for appointments etc.) via phone at (803) 776-4000.

NPI number for Mr Kevin Leon Petersen is 1356676290 and his current mailing address is 115 Red Coat Ln, Columbia, South Carolina. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356676290.

Contact Information

Mr Kevin Leon Petersen, PSYD
6439 Garners Ferry Road, Wjbd Va Medical Center,
Columbia, SC 29209
(803) 776-4000
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMr Kevin Leon Petersen
GenderMale
SpecialityPsychologist
Location6439 Garners Ferry Road, Columbia, South Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1356676290
  • Provider Enumeration Date: 10/09/2009
  • Last Update Date: 10/09/2009

Medical Identifiers

Medical identifiers for Mr Kevin Leon Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356676290NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist (* (Not Available))Primary

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. Mr Kevin Leon Petersen is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Kevin Leon Petersen, PSYD
115 Red Coat Ln,
Columbia, SC 29223-2827

Ph: (602) 790-5900
Mr Kevin Leon Petersen, PSYD
6439 Garners Ferry Road, Wjbd Va Medical Center,
Columbia, SC 29209

Ph: (803) 776-4000

Reviews and Comments


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