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

Mr. Kevin Lee Petersen, LMHC

Individual provider Clinical Psychologist · NPI 1578759270

Mr. Kevin Lee Petersen, LMHC is a Clinical Psychologist in Rochester, Minnesota. Qualified in 2014, 12 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Iowa and Minnesota.

Years since qualifying
12
Licensed in
IA, MN
In the registry since
2007
Specialties on file
2
What do these letters mean?
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.

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Practice location Address checks out

401 16th St SE
Rochester, MN 55904-7973
Phone: (507) 315-4184
Fax: (507) 516-0031
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP6513 (MN)
Mental Health Counselor Taxonomy 101YM0800X · Licence 00399 (IA)

Record details

NPI number1578759270
Entity typeIndividual (Type 1)
GenderMale
Credentials LMHC
Sole proprietorNo
NPI enumeratedSeptember 18, 2007
Last updated in NPPESMarch 13, 2020
Certification dateMarch 13, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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