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TREVOR TODD PETERSON
NPI 1780524595
Counselor in Minneapolis, MN

Active since March 31, 2026PECOS Enrolled
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414(612) 767-7222 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Trevor Todd Peterson NPPES

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

TREVOR TODD PETERSON (NPI 1780524595) is an individual counselor in Minneapolis, Minnesota, licensed in Minnesota (5477) and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1780524595
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameTREVOR TODD PETERSON
Location Address3333 UNIVERSITY AVE SEMinneapolis, MN 55414-3325
Mailing Address3333 University Ave SeMinneapolis, MN 55414-3325
Phone(612) 767-7222
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 31, 2026
Last NPPES UpdateApril 3, 2026
NPPES CertifiedApril 3, 2026
✔ NPI 1780524595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in MN · 5477
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3333 UNIVERSITY AVE SE, Minneapolis, MN 55414
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Trevor Todd Peterson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305316571
PECOS Enrollment IDI20260528003715
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

LYDIA SHULL
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 331-9413
MYSTIC MAKEPEACE
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 767-7222
FATIMA MUHUDIN ALI
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 475-9231
MICAH ALICIA HERNDON
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (201) 589-3367
CHLOE MARGO SARGENT
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 331-9413
MATTHEW LAUREN POWELL
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 331-9413
JAMONDA KELLY
Behavior Technician
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 331-9413
ASHLEY LYNN WITT LPCC
Counselor (Professional)
3333 UNIVERSITY AVE SE
MINNEAPOLIS, MN 55414
Hennepin County (612) 331-9413

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 Trevor Peterson's NPI number?

The NPI number for Trevor Peterson is 1780524595. It was assigned to this individual provider in the NPPES registry on March 31, 2026.

Where is Trevor Peterson located?

Trevor Peterson practices at 3333 University Ave SE, Minneapolis, MN 55414. The listed phone number is (612) 767-7222.

What is Trevor Peterson's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Trevor Peterson enrolled in Medicare?

Yes. Trevor Peterson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Trevor Peterson was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.