Lisa Marie Peterson, LCSW
Individual provider Active NPI Clinical Social Worker · Memphis, MO
NPI 1801038948 · NPPES record last updated Apr 6, 2009
Key facts
- NPI
- 1801038948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2008032217 (MO)
- Practice address
- 215 S Main St
Memphis, MO 63555-1425 - Phone
- (660) 465-7790
- NPI assigned
- Apr 6, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008032217 | MO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2008032217 | MO | Yes |
Addresses
Primary practice location
215 S Main St
Memphis, MO 63555-1425
Mailing address
7816 NW Milrey Dr
Kansas City, MO 64152-2141
Phone (816) 507-1981
Other providers in Memphis, MO
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- Kenneth Bruce Quenneville
- Lois Quenneville
- Nicholas R Rhodes
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All providers in Memphis, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.