Individual provider Active NPI

Courtney L Peterson, LCSW

  • Clinical Social Worker
  • Neenah, WI
National Provider Identifier
1265746242
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8793-123 Issued in WI
Practice address
325 N Commercial St
Neenah, WI 54956-2665
Phone
(920) 725-1230
NPI assigned
Aug 2, 2010
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 7607-M AR
Clinical Social Worker 1041C0700X 8793-123 WI Primary

Addresses

Primary practice location

325 N Commercial St
Neenah, WI 54956-2665

Mailing address

N984 Alexandra Way
Greenville, WI 54942-2304
Phone (920) 770-2090

Other practice location 1

N984 Alexandra Way
Greenville, WI 54942-2304
Phone (920) 770-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250725003648 WI Practitioner - Clinical Social Worker 7810437373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LK Anderson Consulting LLCGroup PAC ID 8325489438, 11 clinicians

Practice addresses (Care Compare)

325 N Commercial St
Neenah, WI 54956-2665
Phone (920) 725-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7607-MARMDSocial Worker
8793-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
LK Anderson Consulting LLC CurrentSince May 17, 2025 Accepting new patients
Radiology Associates of the Fox Valley, SC PastSince May 17, 2025 Accepting new patients

Locations

325 N Commercial St
Neenah, WI 54956
Phone (920) 722-1583

Organizations & group practices 2

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": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1265746242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N984 ALEXANDRA WAY",
            "city": "GREENVILLE",
            "state": "WI",
            "postal_code": "549422304",
            "telephone_number": "920-770-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562665",
            "telephone_number": "920-725-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N984 Alexandra Way",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "WI",
            "postal_code": "549422304",
            "country_code": "US",
            "telephone_number": "920-770-2090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "7607-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8793-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.