Dawn Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW22222 Issued in FL

Practice address

374 Old Dutch Hollow Rd
Monroe, NY 10950-4575

Phone

(845) 721-4778

NPI assigned

May 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Derech Shalom Center IncGroup PAC ID 5496114506, 10 clinicians

Practice addresses (Care Compare)

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.

• The Derech Shalom Center Inc

  • Case Management Agency
  • Suffern, NY
  • NPI 1477295848
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1174197768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 OLD DUTCH HOLLOW RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504575",
            "telephone_number": "845-721-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 OLD DUTCH HOLLOW RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504575",
            "telephone_number": "845-721-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Pendergast, COTA
• Joseph Perechocky, D.D.S.
• Julie Monica Persaud
• Jennifer Pesta
• Diane Peters
• Alexa Noelle Petrassi, OTR/L
• Erin Pfeifer-Andrin, LCSW
• Zahava Pfeiffer, LMSW
• Physician Management Services of New York, LLC
• Carol Pierce, OTR/L

• Clinical Social Worker in Monroe, NY
• Providers in Monroe, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.