Shotunus Denean Peterson, M.S.W

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW Issued in IN

Practice address

108 N Main St
Suite 305
South Bend, IN 46601-1625

Phone

(574) 234-3515

Fax

(574) 234-3565

NPI assigned

Jan 4, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Intrigue Counseling, Inc

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1841248754
  NPD (past)

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1447435755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "address_2": "SUITE 305",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011625",
            "telephone_number": "574-234-3515",
            "fax_number": "574-234-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "address_2": "SUITE 305",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011625",
            "telephone_number": "574-234-3515",
            "fax_number": "574-234-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHOTUNUS",
        "middle_name": "DENEAN",
        "name_prefix": "Ms.",
        "credential": "M.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "MSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Anthony Petersen, PSY.D.
• Sarah Petersen
• Faye Peterson-Pottinger, LCSW
• Charles E Peterson, MD
• Michelle Nicole Peterson, RDN
• Tim Peterson, MA
• Gregory J Pettaway II, MD
• Michael Pfeiffer, D.O.
• Jane P. Philips, RN, MS, OCN, CLT
• Ashley Jordyn Phillips

• Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.