Alexandra Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW92906 Issued in CA

Practice address

15339 Saticoy St
Van Nuys, CA 91406-3345

Phone

(818) 267-2631

NPI assigned

Apr 28, 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 CA

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Therapeutic Alliance a Licensed Clinical Social Worker CoGroup PAC ID 5294119004, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Compass Therapeutic Alliance, a Licensed Clinical Social Worker Co

  • Clinical Social Worker
  • Panorama City, CA
  • NPI 1205572559
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1386021301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15339 SATICOY ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063345",
            "telephone_number": "818-267-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15339 SATICOY ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063345",
            "telephone_number": "818-267-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2021-03-03",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "59998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "59998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW92906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Suh DMD, Inc.
• Kelsey Peterjohn, RBT
• Lori Petermann
• Angeline Peters
• David John Petersen, MD
• Dana Desiree Petrich
• Donara Petrosyan
• Elen Petrosyan, BCBA
• Pamela Pettit
• Shonte'E Elaine Pettus

• Clinical Social Worker in Van Nuys, CA
• Providers in Van Nuys, 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 Mar 3, 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.