Active NPI
Susan K. Peterson, LICSW
- Clinical Social Worker
- Seattle, WA
National Provider Identifier
1013014349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00006437
- Practice address
- 1513 25TH Ave
Seattle, WA 98122-3017 - Phone
- (206) 328-5010
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW00006437 | WA | Primary |
Addresses
Primary practice location
1513 25TH Ave
Seattle, WA 98122-3017
Mailing address
1513 25TH Ave
Seattle, WA 98122-3017
Phone (206) 328-5010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8902748 | Other | WA | L&I CRIME VICTIMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00006437 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1013014349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 25TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981223017",
"telephone_number": "206-328-5010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1513 25TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981223017",
"telephone_number": "206-328-5010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "SUSAN",
"middle_name": "K.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00006437",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CRIME VICTIMS",
"identifier": "8902748",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.