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BECKY PETERSON
NPI 1790182038
Counselor - Mental Health in Champlin, MN

Active since December 02, 2014
8122 113TH AVE N, CHAMPLIN, MN 55316(612) 532-7411 Get Directions Write a Review

NPPES record last updated: December 2, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Becky Peterson NPPES

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

BECKY PETERSON (NPI 1790182038) is an individual mental health provider in Champlin, Minnesota and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1790182038
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameBECKY PETERSON
Location Address8122 113TH AVE NChamplin, MN 55316-3770
Mailing Address8122 113th Ave NChamplin, MN 55316-3770 · (612) 532-7411
Phone(612) 532-7411
Sole ProprietorYes
Enumeration DateDecember 2, 2014
✔ NPI 1790182038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
8122 113TH AVE N, Champlin, MN 55316
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Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-08-2024

  • Opt-Out End Date: 10-08-2026

  • Eligible to Order and Refer? No

Frequently Asked Questions

What is Becky Peterson's NPI number?

The NPI number assigned to this healthcare provider is 1790182038, enumerated as an "individual" on December 02, 2014.

Where is the provider located?

The provider is located at 8122 113TH AVE N CHAMPLIN, MN 55316 and the phone number is (612) 532-7411.

What is the provider's specialty?

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.