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Individual

JAMES PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
152 E STATE ST, BURLINGTON, WI 53105-1940
(262) 763-8183
Mailing address
152 E STATE ST, BURLINGTON, WI 53105-1940
(262) 763-8183

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2095
WI
101YP2500X
Professional Counselor
1610
WI
1041C0700X
Clinical Social Worker
4101
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10908200
WI
Enumeration date
04/09/2007
Last updated
09/11/2025
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