Jennifer Keever Peterken, MSW, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019107 Issued in NC

Practice address

720 N 3Rd St Ste 401
Wilmington, NC 28401-3474

Phone

(910) 769-9126

NPI assigned

Jun 27, 2023

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

Locations

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.

• Family Ties of Brunswick, LLC

  • Professional Counselor
  • Wilmington, NC
  • NPI 1831682665

  Clinical

  NPD
• Stillpoint Counseling and Wellness, PLLC

  • Clinical Social Worker
  • Wilmington, NC
  • NPI 1578043386
  NPD (past)

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1659057172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7019 CAYMAN CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058371",
            "telephone_number": "910-620-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 3RD ST STE 401",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013474",
            "telephone_number": "910-769-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKEN",
        "first_name": "JENNIFER",
        "middle_name": "KEEVER",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Perry, RN, IBCLC
• Kavita S Persaud, M.D.
• Elyse Marie Pertot, M.D.
• Marco Peschiera
• Sarah Nicole Pesquera, BCBA
• Audry Julia Peters, LCSWA
• Joseph Peters, MSW, LCSW
• Nancy C Peters, PH.D.
• Kristian Lee Petersen, L. AC.
• Dana Peterson Dorsett, LCSW

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.