Individual provider · Type 1 NPI
John Anthony Petersen, PSY.D.
Psychologist · South Bend, IN
Practice location
922 E Wayne St # 205
South Bend, IN 46617-3024
Mailing address
208 E Angela Blvd
South Bend, IN 46617-1202
Other practice locations
- 115 S Saint Peter St, South Bend, IN 46617-2912 · (574) 280-8199
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist Primary | 103T00000X | 20041594A (IN) |
Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…
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About NPI 1851491526
John Anthony Petersen, PSY.D.'s National Provider Identifier is 1851491526, issued on Sep 23, 2006. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in South Bend, IN. The record was last updated on Dec 1, 2018.