BECKY PETERSON
NPI 1790182038
Counselor - Mental Health in Champlin, MN
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. She has opted out of Medicare through October 8, 2026.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Becky Peterson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 8, 2024 through October 8, 2026.
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 Becky Peterson's NPI number?
The NPI number for Becky Peterson is 1790182038. It was assigned to this individual provider in the NPPES registry on December 2, 2014.
Where is Becky Peterson located?
Becky Peterson practices at 8122 113th Ave N, Champlin, MN 55316. The listed phone number is (612) 532-7411.
What is Becky Peterson's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Becky Peterson enrolled in Medicare?
No. Becky Peterson has opted out of Medicare through October 8, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Becky Peterson was last updated on December 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Becky Peterson · NPI 1790182038
Mental Health provider in Champlin, Minnesota. Individual provider, active in the CMS NPPES registry since December 2, 2014.
## Identity
- **NPI:** 1790182038 (Entity type: Individual)
- **Enumerated:** December 2, 2014
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8122 113TH AVE N, Champlin, MN 55316-3770
- **Phone:** (612) 532-7411
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through October 8, 2026); services are provided under private contract
## Record status
- **NPPES last updated:** December 2, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1790182038) · Data from the CMS NPPES public registry.