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ANGEL PETERSON
NPI 1003407578
Counselor - Mental Health in Vancouver, WA

Active since January 28, 2021PECOS EnrolledAccepts Medicare Assignment
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661(360) 933-3000 Get Directions Write a Review

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 25, 2022, Jan 20, 2022, Jan 28, 2021 (3 updates tracked since 2021).

About Angel Peterson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANGEL PETERSON (NPI 1003407578) is an individual mental health provider in Vancouver, Washington, licensed in Washington (MC61245796) and active in the NPI registry since January 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1003407578
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameANGEL PETERSON
Location Address6926 NE FOURTH PLAIN BLVDVancouver, WA 98661-7254
Mailing Address6926 Ne Fourth Plain BlvdVancouver, WA 98661-7254
Phone(360) 933-3000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJanuary 28, 2021
Last NPPES UpdateApril 25, 20223 updates tracked since enumeration
NPPES CertifiedApril 25, 2022
✔ NPI 1003407578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · MC61245796
Also ListedCounselorTaxonomy 101Y00000X
6926 NE FOURTH PLAIN BLVD, Vancouver, WA 98661
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Angel Peterson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870088669
PECOS Enrollment IDI20251218004039
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REECE ALEXANDER LINDLEY
Counselor (Mental Health)
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
KAYLA-ANN HAWLEY LICSW, SUDP
Social Worker (Clinical)
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
YOSELYNE JAZMIN MANRERO
Counselor (Mental Health)
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
ALYSE WRIGHT
Counselor (Mental Health)
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
THERESA HARWOOD
Peer Specialist
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
JEFFERY SUMMERVILLE II
Counselor
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
MEGAN B HILL CDP
Counselor (Addiction (Substance Use Disorder))
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000
SONIA WALLER
Registered Nurse (Psychiatric/Mental Health)
6926 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98661
Clark County (360) 993-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angel Peterson's NPI number?

The NPI number for Angel Peterson is 1003407578. It was assigned to this individual provider in the NPPES registry on January 28, 2021.

Where is Angel Peterson located?

Angel Peterson practices at 6926 NE Fourth Plain Blvd, Vancouver, WA 98661. The listed phone number is (360) 933-3000.

What is Angel Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Angel Peterson enrolled in Medicare?

Yes. Angel Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Angel Peterson was last updated on April 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.