MEDICARE: PETERSEN BEHAVIOR CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1356283113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETERSEN BEHAVIOR CONSULTING LLC

Provider Business Mailing Address
First Line	:	103 WORTHINGTON AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96818-5112
Country	:	US
Telephone Number	:	573-760-2488
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 WORTHINGTON AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96818-5112
Country	:	US
Telephone Number	:	573-760-2488
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAUREN PETERSEN
Credential	:	BCBA
Telephone Number	:	573-760-2488

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

Similar Medicare Providers

1689518656 — ANNA BELL NIMMO CBD
Practice Location Address:

6366 PAPAYA LN
HONOLULU, HI
96818-7072

Practice Phone: 502-440-2673
Practice Fax:

1770425548 — JOYCE AGUILAR
Practice Location Address:

4698 OKLAHOMA AVE
HONOLULU, HI
96818-5060

Practice Phone: 228-327-7056
Practice Fax:

1831186998 — MRS. MARY PORTERFIELD JOHNSON RN
Practice Location Address:

4515 PRINCETON PL
HONOLULU, HI
96818-5044

Practice Phone: 808-455-5981
Practice Fax:

1043209026 — MARCUS STEFAN SNYDER MD
Practice Location Address:

755 SCOTT CIRCLE
HONOLULU, HI
96818

Practice Phone: 808-448-6400
Practice Fax:

1821075094 — DR. GRANT Y. FUSATO O.D.
Practice Location Address:

4510 SALT LAKE BLVD , B-11
HONOLULU, HI
96818-3153

Practice Phone: 808-486-9393
Practice Fax: 808-486-9391

1487631438 — COLLEEN MCKOWN-ALLISON LSW
Practice Location Address:

4725 BOUGAINVILLE DR , PMB: 401
HONOLULU, HI
96818-3179

Practice Phone: 507-581-6797
Practice Fax:

Directions to “PETERSEN BEHAVIOR CONSULTING LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.