Clifton Kent Peterson, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123917-3501 Issued in UT

Practice address

9192 S 300 W
Suite 19
Sandy, UT 84070-2671

Phone

(801) 949-1199

NPI assigned

Mar 26, 2013

Last updated

Mar 26, 2013By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1679815864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9192 S 300 W",
            "address_2": "SUITE 19",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702671",
            "telephone_number": "801-949-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9192 S 300 W",
            "address_2": "SUITE 19",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702671",
            "telephone_number": "801-949-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CLIFTON",
        "middle_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "123917-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Sleep Apnea Care
• Russell Edward Peters
• Everett Mark Petersen, M.D.
• Jessica Petersen, PTA
• Mathew Petersen, ABOC
• Holly Sue Peterson, LCSW
• James Wesley Peterson, PHARMD
• Madeline Peterson, RDN
• Marie Ann Peterson, DMD
• Ryan Peterson, CMHC

• Clinical Social Worker in Sandy, UT
• Providers in Sandy, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.