Cynthia B Peterson, MA, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06473 Issued in IA

Practice address

905 Montgomery St
Decorah, IA 52101-2325

Phone

(563) 382-3649

Fax

(563) 382-8183

NPI assigned

Dec 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Northeast Iowa Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Decorah, IA
  • NPI 1710933445
  NPD (past)
• United Community Services, Inc.

  • Point of Service
  • West Des Moines, IA
  • NPI 1609998137
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609937093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY ST",
            "address_2": "P.O. BOX 349",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CYNTHIA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "MA, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISW",
            "identifier": "06473",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisbeth Ann Peirce, LMHC
• Paul D Pellett, MD
• Peter J. Blodgett, DDS
• Peter P. Appell, O.D.,P.C.
• Kathy L Petersburg, ARNP
• Kayla Peterson
• David Liam Pittman, EMT
• Connie Lynn Popenhagen, MSW, LISW, ACADC
• Erin Marie Powers Daley, M.A., CADC
• Karla Mae Presler, LISW

• Clinical Social Worker in Decorah, IA
• Providers in Decorah, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.