AMY KATHLEEN PETERSEN LPC
NPI 1750067823
Counselor - Professional in Zeeland, MI
About Amy Kathleen Petersen Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMY KATHLEEN PETERSEN LPC (NPI 1750067823) is an individual professional provider in Zeeland, Michigan, licensed in Michigan (6401225669) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Hudsonville, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Amy Kathleen Petersen Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Amy Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Rapids, MI 49546
- Reassigned Medicare billing, Michigan enrollment
- 18 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Amy Petersen's NPI number?
The NPI number for Amy Petersen is 1750067823. It was assigned to this individual provider in the NPPES registry on June 23, 2023.
Where is Amy Petersen located?
Amy Petersen practices at 440 S State St, Zeeland, MI 49464. The listed phone number is (616) 741-3790.
What is Amy Petersen's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Amy Petersen enrolled in Medicare?
Yes. Amy Petersen is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Amy Petersen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amy Petersen reassigns Medicare benefits to Grand Rapids Therapy Group Inc (Grand Rapids, MI). The 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 Amy Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Amy Petersen accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Amy 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 Amy Petersen was last updated on August 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Amy Kathleen Petersen, LPC · NPI 1750067823
Professional provider in Zeeland, Michigan. Individual provider, active in the CMS NPPES registry since June 23, 2023.
## Identity
- **NPI:** 1750067823 (Entity type: Individual)
- **Enumerated:** June 23, 2023
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 6401225669 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 440 S STATE ST, Zeeland, MI 49464-2060
- **Phone:** (616) 741-3790 · **Fax:** (616) 741-3792
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grand Rapids Therapy Group Inc (NPI 1295211076, Grand Rapids, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** August 4, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1750067823) · Data from the CMS NPPES public registry.