Doctor Name: | MR. ERIK JON PETERSEN |
NPI Number: | 1003060302 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | LPC.0012435 |
Business Practice Address: | 10350 E Dakota Ave Ste B Denver, CO - 802471314 |
Business Phone Number: | 3033384545 |
Business Fax Number: | |
Mailing Address: | 10350 E Dakota Ave, Ste B DENVER |
State: | CO |
Postal Code: | 802471314 |
Phone Number: | 3033384545 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2008 |
NPI Last Update Date: | 09/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 04/18/2013 |
NPI Reactivation Date: | 05/28/2015 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC.0012435 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |