Active NPI
Debra Ann Peters, LMSW, LPC
- Clinical Social Worker
- Kentwood, MI
National Provider Identifier
1245581925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801057019
- Practice address
- 2180 44TH St SE
Suite 108
Kentwood, MI 49508-5323 - Phone
- (616) 455-1499
- Fax
- (616) 455-1499
- NPI assigned
- Sep 21, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401006602 | MI | |
| Clinical Social Worker | 1041C0700X | 6801057019 | MI | Primary |
Addresses
Primary practice location
2180 44TH St SE
Suite 108
Kentwood, MI 49508-5323
Mailing address
2180 44TH St SE
Suite 108
Kentwood, MI 49508-5323
Phone (616) 455-1499
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401006602 | MI | MD | Professional Counselor |
| 6801057019 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Center for Donor Conception | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Kentwood, MI
- NPI 1104177872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348185600000",
"number": "1245581925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 44TH ST SE",
"address_2": "SUITE 108",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085323",
"telephone_number": "616-455-1499",
"fax_number": "616-455-1499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 44TH ST SE",
"address_2": "SUITE 108",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085323",
"telephone_number": "616-455-1499",
"fax_number": "616-455-1499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "DEBRA",
"middle_name": "ANN",
"credential": "LMSW, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-21",
"last_updated": "2012-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401006602",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801057019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.