Laura Petersen, M.S.W., L.C.S.W., L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004770A Issued in IN

Legal business name

LAURA PETERSEN, M.S.W., L.C.S.W., L.L.C.

Practice address

901 S Rogers St
Suite 202
Bloomington, IN 47403-4756

Phone

(812) 369-7683

NPI assigned

Mar 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Laura Christine Petersen, M.S.W., L.C.S.W.NPI 1548203045

Title

Owner/Therapist

Phone

(812) 369-7683

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Petersen, LCSW

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1548203045
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1063652238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S ROGERS ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034756",
            "telephone_number": "812-369-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S ROGERS ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034756",
            "telephone_number": "812-369-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA PETERSEN, M.S.W., L.C.S.W., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "812-369-7683",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S.W., L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004770A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200887530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Thomas Laucella, MSW, LCSW
• Owen Scott Lauer, DPT
• James J Laughlin, MD
• Susan Glenna Laughlin, FNP
• Laura Lininger, LCSW Counseling Services, LLC
• Amanda Lavender, PMHNP
• Jacob Steven Laverman
• David Eston Lawler, D.D.S.
• Patricia Lawson-Buckley, LMFT
• Richard Lawson

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.