Active NPI
Victoria L Petersen, LSW
- Social Worker
- Matawan, NJ
National Provider Identifier
1578196598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL06519600
- Practice address
- 116 Main Street
Matawan, NJ 07747 - Phone
- (732) 290-9040
- NPI assigned
- Feb 18, 2020
- Last updated
- Feb 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL06519600 | NJ | Primary |
| School Social Worker | 1041S0200X | 1136800 | NJ |
Addresses
Primary practice location
116 Main Street
Matawan, NJ 07747
Mailing address
718 Carol Avenue
Oakhurst, NJ 07755
Phone (732) 278-6339
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL06519600 | NJ | MD | Social Worker |
| 1136800 | NJ | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581984000000",
"number": "1578196598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 CAROL AVENUE",
"city": "OAKHURST",
"state": "NJ",
"postal_code": "07755",
"telephone_number": "732-278-6339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 MAIN STREET",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "07747",
"telephone_number": "732-290-9040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "VICTORIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-18",
"last_updated": "2020-02-18",
"certification_date": "2020-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL06519600",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NJ",
"license": "1136800",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matawan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.