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AUDREY PETERSEN CCC-SLP
NPI 1336694892
Speech-Language Pathologist in Jacksonville, FL

Active since August 24, 2016
12276 SAN JOSE BLVD STE 508, JACKSONVILLE, FL 32223(904) 886-3228 Get Directions Write a Review

NPPES record last updated: September 30, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 30, 2021, Apr 13, 2018, Aug 24, 2016 (3 updates tracked since 2016).

About Audrey Petersen Ccc-slp NPPES

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

AUDREY PETERSEN CCC-SLP (NPI 1336694892) is an individual speech-language pathologist provider in Jacksonville, Florida, licensed in Florida (SA15457) and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1336694892
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameAUDREY PETERSENCredential: CCC-SLP
Location Address12276 SAN JOSE BLVD STE 508Jacksonville, FL 32223-8618
Mailing Address12276 San Jose Blvd Ste 508Jacksonville, FL 32223-8618 · (904) 886-3228
Phone(904) 886-3228
Sole ProprietorNo
Enumeration DateAugust 24, 2016
Last NPPES UpdateSeptember 30, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2021
✔ NPI 1336694892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Licenses✔ Licensed in FL · SA15457✔ Licensed in FL · SZ7762
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
12276 SAN JOSE BLVD STE 508, Jacksonville, FL 32223
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Other Identifiers 1

Medicaid018756200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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.

JESSICA DAILEY DPT
Physical Therapist (Pediatrics)
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
MICHELLE RAMIREZ
Assistant Behavior Analyst
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
MRS. SHANTEL VALERIA BOYKIN
Behavior Technician
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
REBECCA JEWELL WRIGHT
Occupational Therapist
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (322) 890-4886
CAITLIN ELIZABETH COUCH
Music Therapist
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
AMANDA CHAPPELL
Physical Therapist
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
CHELSEA NOWAK BCBA
Behavior Analyst
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228
KATHRYN HARTMAN BISHOP OTRL
Occupational Therapist
12276 SAN JOSE BLVD STE 508
JACKSONVILLE, FL 32223
Duval County (904) 886-3228

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 Audrey Petersen's NPI number?

The NPI number for Audrey Petersen is 1336694892. It was assigned to this individual provider in the NPPES registry on August 24, 2016.

Where is Audrey Petersen located?

Audrey Petersen practices at 12276 San Jose Blvd Ste 508, Jacksonville, FL 32223. The listed phone number is (904) 886-3228.

What is Audrey Petersen's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

What insurance does Audrey Petersen accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Molina Healthcare and Wellpoint list Audrey Petersen 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 Audrey Petersen was last updated on September 30, 2021. 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.