Bethany Peterson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3941 Issued in ND

Practice address

110 15TH St SE
Barnesville, MN 56514-3315

Phone

(218) 329-9345

NPI assigned

Mar 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bethany Peterson, PLLC

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1518688720
  NPD Authorized official

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1134493471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 15TH ST SE",
            "city": "BARNESVILLE",
            "state": "MN",
            "postal_code": "565143315",
            "telephone_number": "218-329-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 15TH ST SE",
            "city": "BARNESVILLE",
            "state": "MN",
            "postal_code": "565143315",
            "telephone_number": "218-329-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BETHANY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3941",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19305",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kindra Larsen-Schultz
• Minnesota Eyecare Network, Inc
• Cynthia Olson
• Owen R Thompson
• Amanda Kay Peterson, D.C.
• Robert A Rostad, DDS
• Jeana R Scheffler, LPCC
• Gregory Kent Sletten, R.PH.
• The Evangelical Lutheran Good Samaritan Society
• Owen R. Thompson

• Clinical Social Worker in Barnesville, MN
• Providers in Barnesville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.