KAYLI PETERSON LPC STUDENT INTERN
NPI 1144871096
Counselor - Mental Health in Dallas, OR
About Kayli Peterson Lpc Student Intern NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAYLI PETERSON LPC STUDENT INTERN (NPI 1144871096) is an individual mental health provider in Dallas, Oregon and active in the NPI registry since September 2019. She has opted out of Medicare through March 4, 2027.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kayli Peterson Lpc Student Intern has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 4, 2025 through March 4, 2027.
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.
DALLAS, OR 97338
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 Kayli Peterson's NPI number?
The NPI number for Kayli Peterson is 1144871096. It was assigned to this individual provider in the NPPES registry on September 23, 2019.
Where is Kayli Peterson located?
Kayli Peterson practices at 182 SW Academy St, Dallas, OR 97338. The listed phone number is (503) 623-9289.
What is Kayli Peterson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kayli Peterson enrolled in Medicare?
No. Kayli Peterson has opted out of Medicare through March 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Kayli Peterson accept?
Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Kayli 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 Kayli Peterson was last updated on November 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Kayli Peterson, LPC STUDENT INTERN · NPI 1144871096
Mental Health provider in Dallas, Oregon. Individual provider, active in the CMS NPPES registry since September 23, 2019.
## Identity
- **NPI:** 1144871096 (Entity type: Individual)
- **Enumerated:** September 23, 2019
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 182 SW ACADEMY ST, Dallas, OR 97338-1996
- **Phone:** (503) 623-9289
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 4, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** November 7, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1144871096) · Data from the CMS NPPES public registry.