Individual
JUSTIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
4004 CARLISLE BLVD NE, ALBUQUERQUE, NM 87107-4565
(505) 270-7733
Mailing address
304 HOMELAND RD NW, ALBUQUERQUE, NM 87114-1614
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CTB20250426
NM
101YM0800X
Mental Health Counselor
CTB-2023-0133
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/16/2021
Last updated
08/20/2025
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