Active NPI
Tanisha Peterson, LCSW
- Clinical Social Worker
- Terrytown, LA
National Provider Identifier
1548629033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1799 Stumpf Blvd Ste 10
Terrytown, LA 70056-3950 - Phone
- (504) 430-6903
- NPI assigned
- Feb 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1799 Stumpf Blvd Ste 10
Terrytown, LA 70056-3950
Mailing address
2350 Park Place Dr Apt 51
Gretna, LA 70056-3074
Phone (504) 430-6903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12200 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1548629033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 PARK PLACE DR APT 51",
"city": "GRETNA",
"state": "LA",
"postal_code": "700563074",
"telephone_number": "504-430-6903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1799 STUMPF BLVD STE 10",
"city": "TERRYTOWN",
"state": "LA",
"postal_code": "700563950",
"telephone_number": "504-430-6903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "TANISHA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-12",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terrytown, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.