| 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 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 0648612978 |
|---|---|
| Medicare Enrollment ID | O20240531000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225612815 | NPI | - | NPPES |
| 0248617 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (NU) | Primary |
| Provider Name | Lindsey Petersen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376914622 PECOS PAC ID: 6709227846 Enrollment ID: I20240531001145 |
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