Individual provider · Type 1 NPI

Jon Walter Petersen, MA, M.ED, LPCC, CMHC

Professional Counselor · St. Louis Park, MN

NPI number 1831735141 Active

Practice location

1155 Ford Rd Ste B
St. Louis Park, MN 55426-1115

Call (952) 378-1800 Map

Fax (952) 378-1714

Mailing address

4240 Park Glen Rd
St. Louis Park, MN 55416-5427

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X12348521-6004 (UT)
Professional Counselor Primary 101YP2500X2463 (MN)

Professional Counselor: Definition to come...

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About NPI 1831735141

Jon Walter Petersen, MA, M.ED, LPCC, CMHC's National Provider Identifier is 1831735141, issued on Nov 21, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis Park, MN. The record was last updated on Jun 13, 2025.