Monique Lolita Peterson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4292C Issued in AL

Practice address

4040 Memorial Pkwy SW BLDG 1
Huntsville, AL 35802-4326

Phone

(256) 533-1970

Fax

(256) 341-0747

NPI assigned

Jun 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Monique Lolita Fields Former name

Medicare fee-for-service enrollment

Enrolled in AL, NC, CA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, NC

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment
• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  AL

  Medicare reassignment
• Mental Health Center of North Central Alabama Inc.

  • Community/Behavioral Health Agency
  • Decatur, AL
  • NPI 1124193636
  NPD (past)

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1649650060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW BLDG 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024326",
            "telephone_number": "256-533-1970",
            "fax_number": "256-341-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW BLDG 1",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024326",
            "telephone_number": "256-533-1970",
            "fax_number": "256-341-0747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1307 E Elm St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356115318",
            "country_code": "US",
            "telephone_number": "256-232-3661",
            "fax_number": "256-341-0747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MONIQUE",
        "middle_name": "LOLITA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "2586G",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4292C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "FIELDS",
            "middle_name": "LOLITA",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Ditoro MD PC
• Amanda Peters, MS, ALC
• Rachel Rockman Petersen, M.D.
• Sam Richard Petersen, CRNP
• Amy E Peterson-Wingo
• Kerriann Pettaway, DNP
• Christy Lynn Pettes, M.D.
• Gracie Deonne Pettus
• Joseph Atkins Pettus IV, M.D.
• Tina Marie Pettway, LPN

• Clinical Social Worker in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.