MEDICARE: ROBYN PETERS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACC-3175	CO
2	101YP2500X	Professional Counselor	LC-465	CO

General Provider Information

NPI Number	:	1154603819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBYN PETERS

Provider Business Mailing Address
First Line	:	PO BOX 1846
Second Line	:
City	:	ESTES PARK
State	:	CO
Zip	:	80517-1846
Country	:	US
Telephone Number	:	970-586-8400
Fax Number	:	970-586-8400

Provider Business Practice Location Address
First Line	:	517 BIG THOMPSON AVE
Second Line	:	SUITE 120
City	:	ESTES PARK
State	:	CO
Zip	:	80517-9661
Country	:	US
Telephone Number	:	970-586-6400
Fax Number	:	970-586-6400

Authorized Official
Title or Position	:	OWNER
Name	:	ROBYN PETERS
Credential	:	LPC, MS, MED
Telephone Number	:	970-586-6400

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	09/19/2011

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Directions to “ROBYN PETERS ” Practice Location

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