DAMON PETERSON M.ED, PBSF
NPI 1194042515
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Petersburg, VA

Q: What is Damon Peterson's NPI number?

The NPI number for Damon Peterson is 1194042515. It was assigned to this individual provider in the NPPES registry on April 24, 2010.

Q: What is Damon Peterson's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Q: When was this NPI record last updated?

The NPPES record for Damon Peterson was last updated on April 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since April 24, 2010

24812 BRICKWOOD MEADOW LN, PETERSBURG, VA 23803(804) 861-5201 Get Directions Write a Review

NPPES record last updated: April 24, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Damon Peterson M.ed, Pbsf NPPES

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

DAMON PETERSON M.ED, PBSF (NPI 1194042515) is an individual community based residential treatment facility, intellectual and/or developmental disabilities provider in Petersburg, Virginia, licensed in Virginia (148) and active in the NPI registry since April 2010.

NPPES Registry Identity

NPI1194042515

Entity TypeIndividualMale

Primary Taxonomy320900000X

Provider Legal NameDAMON PETERSONCredential: M.ED, PBSF

Location Address24812 BRICKWOOD MEADOW LNPetersburg, VA 23803-8869

Mailing AddressPo Box 334Petersburg, VA 23804-0334 · (804) 861-5201

Phone(804) 861-5201

Sole ProprietorYes

Enumeration DateApril 24, 2010

✔ NPI 1194042515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

License✔ Licensed in VA · 148

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

24812 BRICKWOOD MEADOW LN, Petersburg, VA 23803

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Other Identifiers 1

Medicaid0160289598VA

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 Damon Peterson's NPI number?

The NPI number for Damon Peterson is 1194042515. It was assigned to this individual provider in the NPPES registry on April 24, 2010.

Where is Damon Peterson located?

Damon Peterson practices at 24812 Brickwood Meadow Ln, Petersburg, VA 23803. The listed phone number is (804) 861-5201.

What is Damon Peterson's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Damon Peterson was last updated on April 24, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.