Donna Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5339 Issued in ND

Practice address

1500 14TH St SW
Suite 250
Williston, ND 58801

Phone

(701) 334-6242

NPI assigned

Oct 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1346792256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "RAY",
            "state": "ND",
            "postal_code": "588490096",
            "telephone_number": "701-568-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 14TH ST SW",
            "address_2": "SUITE 250",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "58801",
            "telephone_number": "701-334-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DONNA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5339",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khylle Pelmyr Alabanzas Pepino, PT
• Heather Perkins, PTA
• Raquel Peters
• Alison Peterson
• Bailey Peterson
• Jennifer Lee Peterson, RPH
• Linea Ca Peterson
• Lisa M Peterson, PA-C
• Lynn Peterson, RPH
• Oriana Peterson

• Clinical Social Worker in Williston, ND
• Providers in Williston, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.