Teresa Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6730 Issued in OK

Practice address

2010 Boren Blvd
Seminole, OK 74868-2050

Phone

(405) 382-4507

Fax

(405) 382-5269

NPI assigned

Jul 19, 2019

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 OK

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Lighthouse Behavioral Wellness Centers

  • Community/Behavioral Health Agency
  • Ardmore, OK
  • NPI 1518997097
  Medicare reassignment NPD
• Lighthouse Behavioral Wellness Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ardmore, OK
  • NPI 1881884807
  NPD

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1780237602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748181845",
            "telephone_number": "405-382-4507",
            "fax_number": "405-382-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BOREN BLVD",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748682050",
            "telephone_number": "405-382-4507",
            "fax_number": "405-382-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TERESA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-07-31",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "6730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael David Parks
• Ronald Eugene Pauls, PA-C
• Emily Katherine Payne, MSN, FNP-BC
• Rochelle R Payne
• Peak Medical Oklahoma No. 10, Inc.
• Celeste Price, MSCCC-SLP
• Quality Home Medical Equipment
• Elizabeth Ann Ramer
• Curtis Wesley Rawls, B.S.
• Summer Redding

• Clinical Social Worker in Seminole, OK
• Providers in Seminole, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.