Individual provider Active NPI

Morgan Dale Peterman, MSW LSW

  • Social Worker
  • Toledo, OH
National Provider Identifier
1164927299
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2102776 Issued in OH
Practice address
3454 Oak Alley CT Ste 510
Toledo, OH 43606-5526
Phone
(567) 218-0185
Fax
(419) 930-6721
NPI assigned
Mar 29, 2018
Last updated
May 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X I.2102776 OH Primary

Addresses

Primary practice location

3454 Oak Alley CT Ste 510
Toledo, OH 43606-5526

Mailing address

3454 Oak Alley CT Ste 510
Toledo, OH 43606-5526
Phone (567) 218-0185

Other practice location 1

3140 Dustin Rd Ste 1
Oregon, OH 43616-4341
Phone (567) 218-0185

Other identifiers 1

IdentifierTypeStateIssuer
0276805MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203003717 OH Practitioner - Clinical Social Worker 5193251981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drescher and Associates Clinical Services LLCGroup PAC ID 0244666170, 9 clinicians

Practice addresses (Care Compare)

615 Kingsbury St
Maumee, OH 43537-1865
Phone (567) 218-0185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vaitkus Psychological Services LLC CurrentSince Oct 25, 2024 Accepting new patients
Drescher and Associates Clinical Services, LLC CurrentSince Oct 25, 2024 Accepting new patients
Wildwood Counseling Services LLC CurrentSince Feb 11, 2026 Accepting new patients

Locations

615 Kingsbury St
Maumee, OH 43537
Phone (419) 270-2490

3140 Dustin Rd
Ste 1
Oregon, OH 43616
Phone (567) 218-0185

1090 W South Boundary St
Ste 550
Perrysburg, OH 43551
Phone (567) 218-0185

3454 Oak Alley Ct
Ste 510
Toledo, OH 43606
Phone (419) 405-1000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1164927299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 OAK ALLEY CT STE 510",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065526",
            "telephone_number": "567-218-0185",
            "fax_number": "419-930-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 OAK ALLEY CT STE 510",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065526",
            "telephone_number": "567-218-0185",
            "fax_number": "419-930-6721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3140 Dustin Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436164341",
            "country_code": "US",
            "telephone_number": "567-218-0185",
            "fax_number": "419-930-6721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "MORGAN",
        "middle_name": "DALE",
        "credential": "MSW LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2102776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276805",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.