Individual provider Active NPI

Rachel Peterson, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1609830058
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000004389 Issued in TN
Practice address
7220 Wellington Dr
Knoxville, TN 37919-5955
Phone
(865) 588-3173
Fax
(865) 588-3174
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW0000004389 TN Primary

Addresses

Primary practice location

7220 Wellington Dr
Knoxville, TN 37919-5955

Mailing address

PO Box 53314
Knoxville, TN 37950-3314
Phone (865) 588-3173

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

LicenseStateTypeSpecialty
LSW0000004389TNMDClinical Social Worker
4389TNMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Mind Counseling Services, Inc Clinical PastSince Jul 28, 2012 Accepting new patients
Parkwest Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1609830058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53314",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379503314",
            "telephone_number": "865-588-3173",
            "fax_number": "865-588-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 WELLINGTON DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195955",
            "telephone_number": "865-588-3173",
            "fax_number": "865-588-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.