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Individual

MRS. SUSAN DENISE PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT, LMHC,NCC,CSAC

Contact information

Practice address
9040 JACKSON AVENUE, TACOMA, WA 98431-2130
(253) 967-2712
Mailing address
PO BOX 94, GRAHAM, WA 98338-0094
(808) 636-1649

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1674-12
HI
101YM0800X
Mental Health Counselor
MHC 309
HI
106H00000X
Marriage & Family Therapist
Primary
MFT 369
HI

Other

Enumeration date
01/30/2014
Last updated
04/07/2025
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