MEDICARE: DR. EDWARD THOMAS PETEROY

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	103TC0700X	Clinical Psychologist	970	CO

General Provider Information

NPI Number	:	1891891131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD THOMAS PETEROY

Provider Business Mailing Address
First Line	:	PO BOX 1562
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80901-1562
Country	:	US
Telephone Number	:	719-599-7882
Fax Number	:	719-598-1437

Provider Business Practice Location Address
First Line	:	1935 DOMINION WAY
Second Line	:	SUITE A102
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1464
Country	:	US
Telephone Number	:	719-599-7882
Fax Number	:	719-598-1437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1356586721 — JENNIFER CAMILLE HOLCOMB PHD, LMFT, LPC
Practice Location Address:

1935 DOMINION WAY STE 101
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 970-372-7191
Practice Fax:

1255884110 — DR. ERIKA JOHNSON PSYD
Practice Location Address:

1935 DOMINION WAY STE 101
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 719-423-7428
Practice Fax:

1891242905 — MINDFUL CONNECTIONS MENTAL HEALTH, LLC
Practice Location Address:

1935 DOMINION WAY STE 101
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 719-423-7428
Practice Fax:

1558876490 — CHRISTINE ROSEMARK
Practice Location Address:

1935 DOMINION WAY STE 104
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 719-344-8756
Practice Fax:

1477069276 — WHITNEY RICHEAUX-MCDADE MSW; BCBA
Practice Location Address:

1935 DOMINION WAY STE 104
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 719-344-8756
Practice Fax:

1861041394 — TERRI L EASON LPC
Practice Location Address:

1935 DOMINION WAY
COLORADO SPRINGS, CO
80918-1464

Practice Phone: 719-423-7428
Practice Fax:

Directions to “ DR. EDWARD THOMAS PETEROY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.