Patricia Jean Petersen, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05924 Issued in IA

Practice address

5525 Meredith Dr
Des Moines, IA 50310-2334

Phone

(515) 251-4914

NPI assigned

Aug 15, 2005

Reactivated

Mar 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Inner Health Services. Inc

  • Adult Mental Health Clinic/Center
  • Des Moines, IA
  • NPI 1104397223
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356343834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8859 NW 67TH CT",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311900",
            "telephone_number": "515-251-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 MEREDITH DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503102334",
            "telephone_number": "515-251-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "PATRICIA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Peters, DDS
• Angela Kayann Petersen, P.T.
• Ashlee Rae Petersen
• Cody Petersen, MD
• Greta Jane Petersen, PHARMD
• Shannon Marie Petersen, P.T.
• Stacey Rae Petersen, NURSE PRACTITIONER
• Peterson Family Dental, PC
• Alicia Peterson, RN
• Cynthia W Peterson, NP

• Clinical Social Worker in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.