Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154798502 Individual Practitioner Male Practitioner

Charles Peterson

Counselor - Professional • Wethersfield, CT

Professional Overview & Biography Verified Profile Summary

Charles Peterson is a registered healthcare professional specializing in Counselor - Professional in Wethersfield, CT. Practice services are available at 185 SILAS DEANE HWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

185 Silas Deane Hwy

Wethersfield, CT 06109

Telephone 8606981680
Associated Practice Facility / Clinic
🏢 Mindful Actions, Llc Facility NPI 1093080129

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Wethersfield, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.0 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
20 Specialists

Practicing in Wethersfield, CT (2870 Statewide)

Telehealth Adoption Rate
5.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CT 003293

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
115479-8502 (CT)

Secondary Practice Locations

185 Silas Deane Hwy

Wethersfield, CT 06109

Phone: 8606981680

1487 Longmeadow St

Longmeadow, MA 011062204

Phone: 4137268716

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1053281675

Licensed Master Social Worker

Samantha Aldridge , LCSW

Social Worker - Clinical

NPI 1104315001

Licensed Clinical Social Worker

Diana Schneider , LMFT

Marriage & Family Therapist

NPI 1114312238

Licensed Marriage and Family Therapist

NPI 1255434734

Doctor of Optometry

Lexus Tabshey , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1295453926

Psychiatric-Mental Health Nurse Practitioner

Dr. Blerim Rexhaj , PhD

Psychologist - Cognitive & Behavioral

NPI 1871853721

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 11, 2018

Counselor (License #003293 in CT)

📍
Updated Practice Location September 06, 2018

Registered at 185 SILAS DEANE HWY, WETHERSFIELD, CT 06109 (Tel: 8606981680)

📍
Updated Business Mailing Address September 06, 2018

Registered at 1487 LONGMEADOW ST, LONGMEADOW, MA 011062204 (Tel: 4137268716)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 06, 2018

Psychologist

NPI Profile Active September 01, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 01, 2015

Registered at 80 CONGRESS ST STE 106, SPRINGFIELD, MA 011043427 (Tel: 4137391611)

📍
Updated Business Mailing Address September 01, 2015

Registered at 80 CONGRESS ST STE 106, SPRINGFIELD, MA 011043427 (Tel: 4137391611)

👤
Provider Name / Credentials Updated September 01, 2015

Recorded as CHARLES PETERSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 01, 2015

Counselor

🟢
Initial NPI Registration & Enumeration September 01, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154798502
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 01, 2015
Last Update: September 11, 2018
Sole Proprietor: Yes

Mailing Address

1487 Longmeadow St

Longmeadow, MA 011062204

Phone: 4137268716

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.