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General NPI Number Information
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NPI Number | 1154109544
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Entity Type | Individual
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Provider Name | COURTNEY M PETERS LPC-S, LAPC
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Gender | Female
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 211 ARNOLD AVE N
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City | THIEF RIVER FALLS
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State | MN
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Zip | 56701-1827
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Country | US
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Telephone | 701-795-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 17TH AVE S
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City | GRAND FORKS
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State | ND
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Zip | 58201-5372
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Country | US
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Telephone | 701-795-8550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 02875
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1325-9-1-23A
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License Number State | ND
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