Individual provider · Type 1 NPI

Lydia Petersen, LGSW, LADC

Mental Health Counselor · St. Louis Park, MN

NPI number 1285478776 Active

Practice location

5354 Parkdale Dr Fl 3
St. Louis Park, MN 55416-1603

Call (919) 287-6274 Map

Mailing address

1367 Willow St Apt 308
Minneapolis, MN 55403-2578

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X305955 (MN)
Mental Health Counselor Primary 101YM0800X32713 (MN)

Mental Health Counselor: Definition to come...

3 other providers at this address

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About NPI 1285478776

Lydia Petersen, LGSW, LADC's National Provider Identifier is 1285478776, issued on Jun 20, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in St. Louis Park, MN. The record was last updated on Jun 20, 2024.