Stacy M. Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23387 Issued in CA

Practice address

405 Clement St
Suite #2
San Francisco, CA 94118-2317

Phone

(415) 830-0679

NPI assigned

Apr 18, 2010

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1271548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271548800000",
    "number": "1821314774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 GOLDEN GATE AVE",
            "address_2": "APT #408",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941154760",
            "telephone_number": "415-830-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CLEMENT ST",
            "address_2": "SUITE #2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941182317",
            "telephone_number": "415-830-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "STACY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-18",
        "last_updated": "2010-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "23387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Peterson, OTR/L
• Ingrid Abbie Peterson, L.AC., MSOM
• Julia Eve Peterson, DO
• Kristel Peterson, ASW
• Samuel Rhodes Peterson, MD
• Sydnor Peterson
• Willie Lorenzo Peterson Jr., B.A ANTHROPOLOGY
• Tyianna Marie Petithomme
• Laura Petracek, PH.D.
• Lawrence T Petrakis, M.D.

• Clinical Social Worker in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2010; 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.