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MARRISSA MARIE PETERSEN
NPI 1952127367
Counselor - Addiction (Substance Use Disorder) in La Vista, NE

Active since December 02, 2024
12110 PORT GRACE BLVD STE 101, LA VISTA, NE 68128(402) 325-1290 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 22, 2025, Dec 2, 2024 (2 updates tracked since 2024).

About Marrissa Marie Petersen NPPES

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

MARRISSA MARIE PETERSEN (NPI 1952127367) is an individual addiction (substance use disorder) provider in La Vista, Nebraska, licensed in Nebraska (P-2244) and active in the NPI registry since December 2024.

NPPES Registry Identity

NPI1952127367
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMARRISSA MARIE PETERSEN
Location Address12110 PORT GRACE BLVD STE 101La Vista, NE 68128-3190
Mailing Address12110 Port Grace Blvd Ste 101La Vista, NE 68128-3190 · (402) 325-1290
Phone(402) 325-1290
Sole ProprietorNo
Enumeration DateDecember 2, 2024
Last NPPES UpdateMay 22, 20252 updates tracked since enumeration
NPPES CertifiedMay 22, 2025
✔ NPI 1952127367 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NE · P-2244
12110 PORT GRACE BLVD STE 101, La Vista, NE 68128
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Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALISON LAUREN CONDON
Counselor (Professional)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (406) 304-6620
MS. CHLOE JANE ROSMAN
Counselor (Addiction (Substance Use Disorder))
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (406) 304-6620
MS. RASHA RAMAKRISHNAN LIMPH
Counselor (Mental Health)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 645-0038
KRISTEN ADKINS
Counselor (Mental Health)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 645-0038
MS. MICHELLE ANNE MELROY IMHP, MA
Counselor (Mental Health)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 645-0038
CASSANDRA SMITH MSW, LICSW, LADC
Social Worker (Clinical)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 645-0038
CARI HEATHER HAGEMOSER PLMHP
Counselor
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 680-2396
MR. JOSEPH BRENT SUCHANIC MA,LIMHP, LMFT, LCPC
Counselor (Mental Health)
12110 PORT GRACE BLVD STE 101
LA VISTA, NE 68128
Sarpy County (402) 630-6421

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 Marrissa Petersen's NPI number?

The NPI number for Marrissa Petersen is 1952127367. It was assigned to this individual provider in the NPPES registry on December 2, 2024.

Where is Marrissa Petersen located?

Marrissa Petersen practices at 12110 Port Grace Blvd Ste 101, La Vista, NE 68128. The listed phone number is (402) 325-1290.

What is Marrissa Petersen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Marrissa Petersen was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.