Lacey K Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-1046 Issued in WY

Practice address

510 W 29TH St
Cheyenne, WY 82001-2760

Phone

(307) 632-9362

Fax

(307) 637-6852

NPI assigned

Mar 20, 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 names 1

• Lacey Harper 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.

• Longmont United Hospital

  • General Acute Care Hospital
  • Longmont, CO
  • NPI 1366465866
  NPD (past)

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1144595323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-632-9362",
            "fax_number": "307-637-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W 29TH ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012760",
            "telephone_number": "307-632-9362",
            "fax_number": "307-637-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LACEY",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW-1942",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "HARPER",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Warner Peters, MA LPC
• Katie Ann Peters
• Leslie Michelle Peters
• Michael Peters, MD
• Chad William Petersen, DDS
• Amy Kathleen Peterson, M.S., CCC-SLP
• Barry Peterson, CSW
• Jacqueline Alyse Peterson, MSW, LCSW
• Mary J Peterson, RT
• Megan E Peterson, RN

• Clinical Social Worker in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; 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.