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

LicenseStateTypeSpecialty
2008032217MOMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Memphis, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.