Individual provider Active NPI

Rebecca G Peterson

  • Clinical Social Worker
  • Clarkston, MI
National Provider Identifier
1730440306
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801104996 Issued in MI
Practice address
7250 Dixie Hwy Ste 200
Clarkston, MI 48346-5108
Phone
(248) 861-2909
NPI assigned
May 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801104996 MI Primary
Social Worker 104100000X 6802086821 MI

Addresses

Primary practice location

7250 Dixie Hwy Ste 200
Clarkston, MI 48346-5108

Mailing address

236 Waterview Dr
Lake Orion, MI 48362-1547
Phone (248) 863-7735

Other practice location 1

343 River Oaks Dr
Milford, MI 48381-1037
Phone (248) 863-7735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20200214002176 MI Practitioner - Clinical Social Worker 0648606426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lauren Presutti LLCGroup PAC ID 4981026580, 17 clinicians

Practice addresses (Care Compare)

343 River Oaks Dr
Milford, MI 48381-1037
Phone (248) 717-1232

7250 Dixie Hwy
Suite 200
Clarkston, MI 48346-5108
Phone (248) 861-2909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802086821MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lauren Presutti LLC Clinical CurrentSince Jul 30, 2021 Accepting new patients
Grey Street Counseling and Wellness CurrentSince Jan 20, 2025 Accepting new patients

Locations

7250 Dixie Hwy
Ste 400
Clarkston, MI 48346
Phone (248) 861-2909

7250 Dixie Hwy
Ste 200
Clarkston, MI 48346
Phone (248) 861-2909

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1730440306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 WATERVIEW DR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621547",
            "telephone_number": "248-863-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 DIXIE HWY STE 200",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483465108",
            "telephone_number": "248-861-2909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 River Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MI",
            "postal_code": "483811037",
            "country_code": "US",
            "telephone_number": "248-863-7735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "REBECCA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104996",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802086821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.