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CHARLES RANDOLPH PETERSEN
NPI 1417578014
Counselor - Mental Health in Clarkston, WA

Active since May 05, 2020
900 7TH ST, CLARKSTON, WA 99403(508) 758-3341 Get Directions Write a Review

NPPES record last updated: May 5, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Charles Randolph Petersen NPPES

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

CHARLES RANDOLPH PETERSEN (NPI 1417578014) is an individual mental health provider in Clarkston, Washington and active in the NPI registry since May 2020.

NPPES Registry Identity

NPI1417578014
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameCHARLES RANDOLPH PETERSEN
Location Address900 7TH STClarkston, WA 99403-2005
Mailing Address900 7th StClarkston, WA 99403-2005 · (508) 758-3341
Phone(508) 758-3341
Sole ProprietorNo
Enumeration DateMay 5, 2020
NPPES CertifiedMay 5, 2020
✔ NPI 1417578014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
900 7TH ST, Clarkston, WA 99403
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Other Names 1

Professional Name (2)Pete Petersen

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.

JOZLYN HAYS
Counselor
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
ERICK TIMOTHY DAWSON BS
Social Worker
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
CARMEN MARGESON
Counselor (Mental Health)
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
KEELY REED
Counselor (Mental Health)
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
AMELIA BIENIEK
Counselor (Mental Health)
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
NICOLE L THOMASON BSW
Social Worker
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
AISHA NICKELLE LAWSON BSW
Social Worker
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341
SHILO FAYE ROSS
Counselor (Mental Health)
900 7TH ST
CLARKSTON, WA 99403
Asotin County (509) 758-3341

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 Charles Petersen's NPI number?

The NPI number for Charles Petersen is 1417578014. It was assigned to this individual provider in the NPPES registry on May 5, 2020. The provider is also known as Pete Petersen.

Where is Charles Petersen located?

Charles Petersen practices at 900 7th St, Clarkston, WA 99403. The listed phone number is (508) 758-3341.

What is Charles Petersen's specialty?

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

When was this NPI record last updated?

The NPPES record for Charles Petersen was last updated on May 5, 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.