Denise J Petrich

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23359 Issued in MN

Practice address

1818 Wooddale Dr Ste 110
Woodbury, MN 55125-2947

Phone

(651) 485-4380

NPI assigned

Jun 26, 2024

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

Enrolled in MN

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 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Reflections Counseling PC

  • Clinical Social Worker
  • Woodbury, MN
  • NPI 1346665981
  Medicare reassignment

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1669217113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3673 LEXINGTON AVE N STE H-2101",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551262984",
            "telephone_number": "651-485-4380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WOODDALE DR STE 110",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252947",
            "telephone_number": "651-485-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICH",
        "first_name": "DENISE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Daniel Peterson, PA-C
• Ramsey Evan Peterson, MD
• Tyler James Peterson, D.C.
• Amanda Jo Petri, M.A.
• Stacey S Petric, ATC
• Jordan Petryniec
• Pamela Jean Pfromm
• Elizabeth Pharr
• Chloe Johnson Philion, OTR/L
• PHS Woodbury, Inc

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.