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MRS. TANDICE PETERSON
NPI 1104199074
Counselor - Mental Health in Pocatello, ID

Active since February 22, 2012
1777 E CLARK ST STE 210, POCATELLO, ID 83201(208) 427-5891(208) 427-5895 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Tandice Peterson NPPES

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

MRS. TANDICE PETERSON (NPI 1104199074) is an individual mental health provider in Pocatello, Idaho and active in the NPI registry since February 2012.

NPPES Registry Identity

NPI1104199074
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. TANDICE PETERSON
Location Address1777 E CLARK ST STE 210Pocatello, ID 83201-3357
Mailing Address1777 E Clark St Ste 210Pocatello, ID 83201-3357 · (208) 427-5891 · Fax (208) 427-5895
Phone(208) 427-5891
Fax(208) 427-5895
Sole ProprietorYes
Enumeration DateFebruary 22, 2012
Last NPPES UpdateJuly 11, 2023
NPPES CertifiedJuly 11, 2023
✔ NPI 1104199074 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
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License LCPC-7004 (ID)
1777 E CLARK ST STE 210, Pocatello, ID 83201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

PATHWAY COUNSELING
Clinic/Center (Mental Health (Including Community Mental Health Center))
1777 E CLARK ST STE 210
POCATELLO, ID 83201
Bannock County (208) 427-5891
MEGAN OLSEN BIRD PH.D.
Psychologist (Clinical)
1777 E CLARK ST STE 210
POCATELLO, ID 83201
Bannock County (208) 203-2088

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 Tandice Peterson's NPI number?

The NPI number for Tandice Peterson is 1104199074. It was assigned to this individual provider in the NPPES registry on February 22, 2012.

Where is Tandice Peterson located?

Tandice Peterson practices at 1777 E Clark St Ste 210, Pocatello, ID 83201. The listed phone number is (208) 427-5891.

What is Tandice Peterson's specialty?

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

What insurance does Tandice Peterson accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Tandice Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tandice Peterson was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.