Shayla Tramaine Peterson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5975 Issued in TN

Practice address

286 Clear Sky CT Ste a
Clarksville, TN 37043-8919

Phone

(931) 820-1021

Fax

(931) 820-1031

NPI assigned

Apr 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shayla Monroe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Strengths and Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hallandale Beach, FL
  • NPI 1518508779
  NPD (past)

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1124448105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 CLEAR SKY CT STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438919",
            "telephone_number": "931-820-1021",
            "fax_number": "931-820-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 CLEAR SKY CT STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438919",
            "telephone_number": "931-820-1021",
            "fax_number": "931-820-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHAYLA",
        "middle_name": "TRAMAINE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11763",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "SW5975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYLA",
            "last_name": "MONROE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Muriel Petersheim
• Alexa Renee Peterson, DO
• Christine Louise Peterson, CNM, ARNP
• Damonei Timmia Peterson
• Helen Taylor Peterson, DC
• Shamiyah Donsha Petersoon
• Daisha Petgrave
• Kristina Petrino
• Alan Joseph Pettipas, BA
• Jamisha Janelle Pettis

• Clinical Social Worker in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.