Healthcare Provider Details

I. General information

NPI: 1982555132
Provider Name (Legal Business Name): LINDSEY PETERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S KANSAS AVE STE 311
NORTON KS
67654-2147
US

IV. Provider business mailing address

602 N GRANT AVE
NORTON KS
67654-1204
US

V. Phone/Fax

Practice location:
  • Phone: 785-877-0450
  • Fax:
Mailing address:
  • Phone: 785-877-0450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC05375
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: