Laura Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004770 Issued in IN

Practice address

901 S Rogers St
Suite 202
Bloomington, IN 47403-4756

Phone

(812) 369-7683

NPI assigned

Jun 13, 2006

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

Enrolled in IN

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

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Laura Petersen, M.S.W., L.C.S.W., L.L.C.

  • Clinical Social Worker
  • Bloomington, IN
  • NPI 1063652238
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1548203045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S ROGERS ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034756",
            "telephone_number": "812-369-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S ROGERS ST",
            "address_2": "SUITE 202",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034756",
            "telephone_number": "812-369-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LAURA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J Persley, LCSW
• Lainey Peter
• Allison V Peters, PA-C
• Asia Peters
• Jennifer Petersen-Goldspiel, M.D.
• Elizabeth Peterson, OT
• Erica Christine Peterson, RN
• Courtney Petrie
• Misty Susanne Petro, PTA,ATC,CSCS
• Kaitlyn Petrow

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.