Shelly Anne Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

57467 Issued in TX

Practice address

25511 Budde Rd Ste 1502
The Woodlands, TX 77380-2081

Phone

(936) 727-0596

NPI assigned

Oct 11, 2018

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1609341122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE 1502",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE 1502",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802081",
            "telephone_number": "936-727-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHELLY",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanna D Pete, PHARM.D.
• Peter D. Franklin M.D. P.a.
• James Joseph Peters, LCSW
• Gina Grace Peterson, MSN, APRN, CPNP-AC
• Jason Lee Peterson, PHYSICAL THERAPIST
• Isabella Pethe, APRN-CNP
• Samantha R. Petillon, PT, DPT
• Kimberly B Petrie, M.S. CCC-SLP
• Tracy N Petrocelli
• Haley Pettigrew, MS, LMFT, LCDC

• Clinical Social Worker in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.