Jennifer Peterson, MSW, LISW-S

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.1800853 Issued in OH

Practice address

2587 Back Orrville Rd
Wooster, OH 44691-9523

Phone

(330) 264-9597

Fax

(330) 264-0946

NPI assigned

Jun 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Social Worker

Education

University of New England, College of Osteo Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oneeighty, IncGroup PAC ID 7214244748, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oneeighty, Inc.

  • Community/Behavioral Health Agency
  • Wooster, OH
  • NPI 1710244637
  Medicare reassignment Care Compare group
• Anazao Community Partners

  • Community/Behavioral Health Agency
  • Wooster, OH
  • NPI 1073873923
  NPD (past)
• Anazao Community Partners

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wooster, OH
  • NPI 1164471082
  NPD (past)

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1275913410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 BACK ORRVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919523",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2587 BACK ORRVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919523",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENNIFER",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1302385",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1800853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Scott Pesicek, D.D.S.
• Andrew Michael Peters, LPN
• Dawn E Peters, MA, LPCC
• Nichole Lee Peters, LSW
• Allison Peterson, LISW
• Kenna Peterson
• Kylie Brianne Peterson
• Ashlie Pethtel, LISW, MSW
• Julia Pettay
• Kristina M Pettorini, BA, QMHS

• Social Worker in Wooster, OH
• Providers in Wooster, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.