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KIRSTEN E PETERSEN, PHD
NPI 1366067258
Psychologist - Clinical in Wantagh, NY

Active since June 16, 2020
2389 BABYLON ST, WANTAGH, NY 11793(917) 991-1042 Get Directions Write a Review

NPPES record last updated: June 17, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kirsten E Petersen, Phd NPPES

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

KIRSTEN E PETERSEN, PHD (NPI 1366067258) is a healthcare organization registered as a clinical in Wantagh, New York and active in the NPI registry since June 2020. The organization lists Kirsten Erin Petersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1366067258
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameDR. KIRSTEN E. PETERSEN PSYCHOLOGICAL SERVICES, PLLC
Location Address2389 BABYLON STWantagh, NY 11793-4501
Mailing Address2389 Babylon StWantagh, NY 11793-4501 · (917) 991-1042
Phone(917) 991-1042
Organization SubpartNo
Authorized OfficialKirsten Erin PetersenOwner · (917) 991-1042
Enumeration DateJune 16, 2020
Last NPPES UpdateJune 17, 2020
NPPES CertifiedJune 17, 2020
✔ NPI 1366067258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2389 BABYLON ST, Wantagh, NY 11793
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Other Names 1

Doing Business AsKirsten E Petersen, Phd

Other Identifiers 2

Other901260Beacon Health Options
OtherV53P52NY · Empire Bluecross Blueshield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kirsten E Petersen, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Kirsten E Petersen, Phd, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kirsten Petersen, PHD
Clinical Psychologist
NPI 1831581594
2389 BABYLON ST
Wantagh, NY 11793
(917) 991-1042
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Dr. Kirsten E. Petersen Psychological Services, PLLC's NPI number?

The NPI number for Dr. Kirsten E. Petersen Psychological Services, PLLC is 1366067258. It was assigned to this organization in the NPPES registry on June 16, 2020. The provider is doing business as Kirsten E Petersen, Phd.

Where is Dr. Kirsten E. Petersen Psychological Services, PLLC located?

Dr. Kirsten E. Petersen Psychological Services, PLLC is located at 2389 Babylon St, Wantagh, NY 11793. The listed phone number is (917) 991-1042.

What is Dr. Kirsten E. Petersen Psychological Services, PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Dr. Kirsten E. Petersen Psychological Services, PLLC enrolled in Medicare?

Yes. Dr. Kirsten E. Petersen Psychological Services, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dr. Kirsten E. Petersen Psychological Services, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Dr. Kirsten E. Petersen Psychological Services, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Dr. Kirsten E. Petersen Psychological Services, PLLC was last updated on June 17, 2020. 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.