Active NPI
Deborah A Peterman, MSW CADCIII
- Addiction (Substance Use Disorder) Counselor
- Manitowoc, WI
National Provider Identifier
1659391605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1998
- Practice address
- 339 Reed Ave
Manitowoc, WI 54220-2020 - Phone
- (920) 320-8600
- Fax
- (920) 320-8662
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1998 | WI | Primary |
| Clinical Social Worker | 1041C0700X | 189-123 | WI |
Addresses
Primary practice location
339 Reed Ave
Manitowoc, WI 54220-2020
Mailing address
PO Box 2290
Manitowoc, WI 54221-2290
Phone (920) 320-8600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39706900 | Medicaid | WI | |
| 40437 | Other | NETWORK HEALTH PLAN | |
| S91262 | Other | CIGNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1998 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 189-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deborah Peterman Counseling | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Shawano, WI
- NPI 1255567608
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1659391605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2290",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542212290",
"telephone_number": "920-320-8600",
"fax_number": "920-320-8662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 REED AVE",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542202020",
"telephone_number": "920-320-8600",
"fax_number": "920-320-8662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERMAN",
"first_name": "DEBORAH",
"middle_name": "A",
"credential": "MSW CADCIII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "1998",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "189-123",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39706900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH PLAN",
"identifier": "40437",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "S91262",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.