Kailey Peterson, MSW, CAPSW, SAC-IT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

132464-121 Issued in WI

Practice address

1409 Emil St
Madison, WI 53713-2311

Phone

(608) 421-3406

Fax

(608) 283-6374

NPI assigned

Feb 10, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Arc Community Services, Inc.

  • Community/Behavioral Health Agency
  • Madison, WI
  • NPI 1962603522
  NPD (past)

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1154075836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 EMIL ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132311",
            "telephone_number": "608-421-3406",
            "fax_number": "608-283-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 EMIL ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132311",
            "telephone_number": "608-421-3406",
            "fax_number": "608-283-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KAILEY",
        "credential": "MSW, CAPSW, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19452-130",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "132464-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeterson@arccommserv.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "work email",
            "address_1": "1409 Emil St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537132311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeannie Peterson
• Jeffrey S Peterson
• Jennifer Peterson, LPC, LMHC
• Joe R Peterson, P.A.
• Joshua Peterson, MSW
• Kyle Peterson, LCSW
• Lacey Marie Peterson, CPTA
• Madelon Mae Peterson, MD
• Megan Anne Peterson
• Megan F Peterson, NP

• Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.