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General NPI Number Information
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NPI Number | 1588524409
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Entity Type | Organization
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Legal Business Name | JNPETERSON
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 811 E WASHINGTON AVE # 401
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City | MADISON
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State | WI
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Zip | 53703-3688
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Country | US
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Telephone | 608-616-9636
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Fax |
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Provider Business Mailing Address
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Address Line | 811 E WASHINGTON AVE # 401
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City | MADISON
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State | WI
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Zip | 53703-3688
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Country | US
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Telephone | 608-616-9636
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOTHERAPIST
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Name | JENNIFER PETERSON
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Credential | LPC, LMHC,
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Telephone | 608-515-1255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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