Organization
DR. KIRSTEN E. PETERSEN PSYCHOLOGICAL SERVICES, PLLC
Active
Other names
Kirsten E Petersen, PhD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRSTEN ERIN PETERSEN (OWNER)
(917) 991-1042
Entity
Organization
Contact information
Practice address
2389 BABYLON ST, WANTAGH, NY 11793-4501
(917) 991-1042
Mailing address
2389 BABYLON ST, WANTAGH, NY 11793-4501
(917) 991-1042
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
901260
BEACON HEALTH OPTIONS
—
01
—
V53P52
EMPIRE BLUECROSS BLUESHIELD
NY
Enumeration date
06/16/2020
Last updated
06/17/2020
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