Lisa Marie Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2008032217 Issued in MO

Practice address

215 S Main St
Memphis, MO 63555-1425

Phone

(660) 465-7790

NPI assigned

Apr 6, 2009

Last updated

Apr 6, 2009By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1801038948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7816 NW MILREY DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641522141",
            "telephone_number": "816-507-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S MAIN ST",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635551425",
            "telephone_number": "660-465-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2008032217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell Lynn Monroe, DC
• Northeast Missouri Health Council Inc (Memphis Community Health Center)
• Northeast Missouri Health Council, Inc. (Northeast Missouri Family Health Clinic)
• Susanne Renee Owens, CRNA
• Kylee Nichole Perkins, PTA
• Pkanesthesia, Inc
• Kenneth Bruce Quenneville, MD
• Lois Quenneville, P.A.
• Nicholas R Rhodes, L.M.T
• Scotland Co. R-1

• Clinical Social Worker in Memphis, MO
• Providers in Memphis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.