Individual provider Active NPI

Elizabeth Susan Peters, MA

  • Clinical Social Worker
  • Ridgewood, NJ
National Provider Identifier
1154573640
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
120 Chesnut Street
Ridgewood, NJ 07450
Phone
(201) 444-3550
Fax
(201) 652-1613
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

120 Chesnut Street
Ridgewood, NJ 07450

Mailing address

120 Chesnut Street
Ridgewood, NJ 07450
Phone (201) 444-3550

Other names 1

  • Ms. Elizabeth Susan Engstrom Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1154573640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHESNUT STREET",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-3550",
            "fax_number": "201-652-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHESNUT STREET",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-3550",
            "fax_number": "201-652-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ENGSTROM",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "credential": "MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.