ANGEL PETERSON – Mental Health Counselor, NPI 1003407578

ANGEL PETERSON is a healthcare provider. based in Vancouver, Washington. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. MC61245796 (WA). The NPI Number for ANGEL PETERSON is 1003407578

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
ANGEL PETERSON
NPI
1003407578
Phone
Not provided
Address
6926 NE FOURTH PLAIN BLVD
Enumeration Date
28 January 2021
Last Update Date
25 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604339664
Graduation Year
2019 (7 years ago)
PAC ID
3870088669
Group Practice PAC ID
2365965985
Professional Enrollment ID
I20251218004039
Address ID
WA986852711VA13505AVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,452 MENTAL HEALTH COUNSELOR in WA

Provider Addresses for ANGEL PETERSON

  • 6926 NE FOURTH PLAIN BLVD

    VANCOUVER, WA 986617254

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251218004039IMental Health CounselorWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98661)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365965985View full group profile
NameSpecialtyState
Mental Health CounselorTX
Marriage And Family TherapistWA
Mental Health CounselorWA
Marriage And Family TherapistOR
Mental Health CounselorOR
Mental Health CounselorWA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is ANGEL PETERSON's NPI number?
ANGEL PETERSON's NPI is 1003407578 — the number used across U.S. healthcare to identify this provider.
Is ANGEL PETERSON still an active registrant?
ANGEL PETERSON carries an active NPI according to the public dataset.
What expertise is attributed to ANGEL PETERSON?
ANGEL PETERSON's specialty line reads Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is ANGEL PETERSON located near Vancouver?
ANGEL PETERSON currently maps to Vancouver, Washington in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

Similar Providers

CHARLES E. BARNARD (MA, LMHC)

Mental Health Counselor
Northwest Legal Advocates, 1104, Main Street, Officers Row, Vancouver, Clark County, Washington, 98660, United States
NPI: 1831180728
Surrey Parks 110A Sullivan Street Sports Box, Sullivan Street, Crescent Beach, South Surrey, Surrey, Metro Vancouver Regional District, British Columbia, V4A 3V2, Canada
NPI: 1285605717

DR. JAMES CRAIG THOMAS (PSY.D.)

Mental Health Counselor
Colony, 2904, Main Street, Mount Pleasant, Vancouver, District of North Vancouver, Metro Vancouver Regional District, British Columbia, V5T 3E8, Canada
NPI: 1538133921

Unknown Individual

Mental Health Counselor
Providence Academy, 400, East Evergreen Boulevard, Officers Row, Vancouver, Clark County, Washington, 98660, United States
NPI: 1649247263

JORDAN M FEIGAL (MS, LMHC)

Mental Health Counselor
1115 SE 164TH AVE DEPT 358
NPI: 1134196504

MARY FONTANA (LMHC)

Mental Health Counselor
Northwest Legal Advocates, 1104, Main Street, Officers Row, Vancouver, Clark County, Washington, 98660, United States
NPI: 1336196088

MR. DAVID CAMERON HUNTER (M.S.)

Mental Health Counselor
Bodega, 1014, Main Street, Strathcona, Vancouver, District of North Vancouver, Metro Vancouver Regional District, British Columbia, V6A, Canada
NPI: 1053347070

THERESA (TERRY CAPPIELLO (LMHC)

Mental Health Counselor
110, Columbia Street, Officers Row, Vancouver, Clark County, Washington, 98660, United States
NPI: 1386669141

MR. JEFFERY FRANKLIN FOSTER (QMHP)

Mental Health Counselor
1712, Southeast 111th Court, Ellsworth Springs, Vancouver, Clark County, Washington, 98664, United States
NPI: 1366464570