Wisdom Tree Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS28561 Issued in CA

Legal business name

WISDOM TREE COUNSELING

Practice address

10601 Civic Center Dr
Suite 100-M
Rancho Cucamonga, CA 91730-3878

Phone

(909) 291-9349

NPI assigned

Oct 11, 2016

Organization subpart

No

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

Authorized official

Name

Jeraleen M Peterson, LCSWNPI 1063635563

Title

Owner

Phone

(909) 291-9349

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeraleen M. Peterson, LCSW

  • Clinical Social Worker
  • Rancho Cucamonga, CA
  • NPI 1063635563
  NPD (past) Authorized official

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1346790524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 CIVIC CENTER DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303878",
            "telephone_number": "909-291-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 CIVIC CENTER DR",
            "address_2": "SUITE 100-M",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303878",
            "telephone_number": "909-291-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM TREE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JERALEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-291-9349",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS28561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina M Winfrey
• Jean A Winston, RN
• Winthrop Chiropractic Corporation Apc
• Andrew Winthrop, DC
• Nancy Wirz, MFT
• Thomas Alan Wise, AU.D.
• Kayla Wojciechowski
• Ronette Letania Wolfe
• Victoria Wolfe
• Joshua Womack

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.