Active NPI
Barry Peterson, CSW
- Clinical Social Worker
- Cheyenne, WY
National Provider Identifier
1821381906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW-115
- Practice address
- 3304 E I-80 Service Rd
Cheyenne, WY 82009-8781 - Phone
- (307) 633-8040
- NPI assigned
- May 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW-115 | WY | Primary |
Addresses
Primary practice location
3304 E I-80 Service Rd
Cheyenne, WY 82009-8781
Mailing address
3304 E I-80 Service Rd
Cheyenne, WY 82009-8781
Phone (307) 633-8040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW-115 | WY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306108800000",
"number": "1821381906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3304 E I-80 SERVICE RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820098781",
"telephone_number": "307-633-8040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3304 E I-80 SERVICE RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820098781",
"telephone_number": "307-633-8040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "BARRY",
"credential": "CSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-23",
"last_updated": "2011-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WY",
"license": "CSW-115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.