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Ms. Judeth Petersen, MA,LPC
Counselor in Gillette, Wyoming
NPI 1033263652

Judeth Petersen is a Counselor based in Gillette, WY. Judeth Petersen practices in Gillette, WY and has the professional credentials of MA,LPC. The NPI Number for Judeth Petersen is 1033263652 and holds a License No. 1512 (Wyoming).

The current practice location address for Judeth Petersen is 501 S Burma Ave, Gillette, WY and can be reached out via phone at 307-688-5000 and via fax at 307-688-5015.

Location: 501 S Burma Ave, Gillette, WY, 82716-3426
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033263652
Provider Name
Judeth Petersen
Credential
MA,LPC
Provider Entity Type
Individual
Gender
Female
Address
501 S Burma Ave, Gillette, WY, 82716-3426
Phone Number
307-688-5000
Fax Number
307-688-5015
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LPC-1129 01 WY STATE OF WYOMING MENTAL HEALTH PROFESSIONS LICENSING BOARD
institution
Provider Business Practice Location Address Details
Address
501 S Burma Ave
City
Gillette
State
Wyoming
Zip
82716-3426
Phone Number
307-688-5000
Fax Number
307-688-5015
person
Provider Business Mailing Address Details
Address
501 S Burma Ave
City
Gillette
State
Wyoming
Zip
82716-3426
Phone Number
307-688-5000
Fax Number
307-688-5015
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
LPC-1129 (Wyoming)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
1512 (North Dakota)
Definition
Definition to come...
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