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General NPI Number Information
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NPI Number | 1841381332
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Entity Type | Individual
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Provider Name | RICHARD M PETERSEN L.M.F.T. M.A.C.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | USAMEDDAC WUERZBURG, ANSBACH MIDDLE HIGH SCHOOL
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City | ANSBACH
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State | GERMANY
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Zip | 09177
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Country | DE
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Telephone | 09802832153
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Fax | 098021496
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Provider Business Mailing Address
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Address Line | USAMEDDAC WUERZBURG, UNIT 26610 ATTN: CREDENTIALS OFFICE
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City | APO
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State | AE
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Zip | 09244
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Country | DE
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Telephone | 01149931843616
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Fax | 011499318043241
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | B23678
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | #36434
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License Number State | CA
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