Petersen, Jon Walter

Petersen, Jon Walter is an individual health care provider with primary practice located at 1155 Ford Rd Ste B , St Louis Park MN 55426-1115. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Petersen, Jon Walter can be contacted via phone (952) 378-1800.

Contact Information

Primary practice address
1155 Ford Rd Ste B St Louis Park MN 55426-1115
Phone: (952) 378-1800
Fax: (952) 378-1714
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 12348521-6004 Utah
Behavioral Health & Social Service Providers / Professional 101YP2500X 2463 Minnesota

Profile Details

NPI number 1831735141
LBN Legal business name Petersen, Jon Walter
Credentials MA, M.ED, LPCC, CMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2019
Last updated Jun 13th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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