Carolyn Wasik-Petersen, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR046337-1 Issued in NY

Practice address

19 North St
Middle Island, NY 11953-1757

Phone

(516) 380-0005

NPI assigned

Jan 22, 2015

Last updated

Jan 22, 2015By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1619366085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 NORTH ST",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119531757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 NORTH ST",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119531757",
            "telephone_number": "516-380-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIK-PETERSEN",
        "first_name": "CAROLYN",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR046337-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Rite Aid)
• Margaret L. Wallace, MS
• Amanda Ivy Walsh, M.A.
• Rebecca Walsh
• Terrence Allen Walsh
• Kaitlyn Amber Watson
• Malka Dina Weiss
• Veronica Lynn Wekerle, B.A.
• Amanda Welch, LCSW
• Mayobanex Wentworth

• Clinical Social Worker in Middle Island, NY
• Providers in Middle Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.