Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Polly W. Peterson, PHD

Organization Psychologist · NPI 1427702091

Polly W. Peterson, PHD is a Psychologist in Orange Park, Florida. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

1543 Kingsley Ave Ste 14
Orange Park, FL 32073-4570
Phone: (904) 742-8235
Fax: (904) 217-7222
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X

Record details

NPI number1427702091
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Polly Peterson — Psychologist/Owner · (904) 742-8164
NPI enumeratedFebruary 11, 2022
Last updated in NPPESFebruary 11, 2022
Certification dateFebruary 11, 2022
Mailing address2465 Us Highway 1 S Unit 154, Saint Augustine, FL 32086-6076

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