# LISA A PETERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1962514869
- **Gender:** F
- **Credential:** LMHC LCDP LCDCS MAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | MHC00235 | RI | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | LCDP00129 | RI | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 06/10/2025