Active NPI
Nicole Reed Petersen, MSW
- Clinical Social Worker
- Hastings, NE
National Provider Identifier
1750736534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7057
- Practice address
- 835 S Burlington Ave
Ste 108
Hastings, NE 68901-6960 - Phone
- (402) 463-7711
- NPI assigned
- Apr 28, 2016
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10838 | NE | |
| Clinical Social Worker | 1041C0700X | 7057 | NE | Primary |
Addresses
Primary practice location
835 S Burlington Ave
Ste 108
Hastings, NE 68901-6960
Mailing address
835 S Burlington Ave
Ste 108
Hastings, NE 68901-6960
Phone (402) 463-7711
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7057 | NE | MD | Clinical Social Worker |
| 10838 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1750736534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 S BURLINGTON AVE",
"address_2": "STE 108",
"city": "HASTINGS",
"state": "NE",
"postal_code": "689016960",
"telephone_number": "402-463-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 S BURLINGTON AVE",
"address_2": "STE 108",
"city": "HASTINGS",
"state": "NE",
"postal_code": "689016960",
"telephone_number": "402-463-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "NICOLE",
"middle_name": "REED",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-28",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "10838",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "7057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hastings, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.