Theresa Ann Peterson, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CW015447 Issued in PA

Practice address

4845 W Lake Rd Ste 102
Erie, PA 16505-2973

Phone

(814) 218-3054

Fax

(814) 725-0707

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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 PA

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Theresa Peterson-Hadden, LLC

  • Clinical Social Worker
  • Erie, PA
  • NPI 1366801250
  Medicare reassignment NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1760534416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 W LAKE RD STE 102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052973",
            "telephone_number": "814-218-3054",
            "fax_number": "814-725-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 W LAKE RD STE 102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052973",
            "telephone_number": "814-218-3054",
            "fax_number": "814-725-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW015447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Desiree Peterson
• Meg Peterson
• Renee Lynn Peterson, O.D.
• Robert Schaefer Peterson, MED
• Ross C Peterson, MD
• Petkac Psychotherapy Services
• John S. Petkac, LPC
• Maryna Petrasheuskaya, DDS
• Megan Claire Petrilla, ATC
• Adam J Petroski, DO

• Mental Health Counselor in Erie, PA
• Providers in Erie, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.