DR. KATHLEEN MICHELLE PETERSEN PHD
NPI 1609510858
Psychologist - School in Excelsior, MN

Active since April 25, 2022
202 WATER ST STE 208, EXCELSIOR, MN 55331(612) 615-3575 Get Directions Write a Review

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kathleen Michelle Petersen Phd NPPES

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

DR. KATHLEEN MICHELLE PETERSEN PHD (NPI 1609510858) is an individual school provider in Excelsior, Minnesota, licensed in Minnesota (5567) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1609510858
Entity TypeIndividualFemale
Primary Taxonomy103TS0200X
Provider Legal NameDR. KATHLEEN MICHELLE PETERSENCredential: PHD
Location Address202 WATER ST STE 208Excelsior, MN 55331-1887
Mailing Address202 Water St Ste 208Excelsior, MN 55331-1887 · (612) 615-3575
Sole ProprietorYes
Enumeration DateApril 25, 2022
NPPES CertifiedFebruary 16, 2022
NPI 1609510858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in MN · 5567
Definition
A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
202 WATER ST STE 208, Excelsior, MN 55331

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 Kathleen Petersen's NPI number?

The NPI number for Kathleen Petersen is 1609510858. It was assigned to this individual provider in the NPPES registry on April 25, 2022.

Where is Kathleen Petersen located?

Kathleen Petersen practices at 202 Water St Ste 208, Excelsior, MN 55331. The listed phone number is (612) 615-3575.

What is Kathleen Petersen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in School, with taxonomy code 103TS0200X.

When was this NPI record last updated?

The NPPES record for Kathleen Petersen was last updated on April 25, 2022. 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.