Marcela A Peterson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114499-01 Issued in NY

Practice address

462 1St Ave
New York, NY 10016-9196

Phone

(212) 562-8675

NPI assigned

Apr 8, 2022

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1821730136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 74TH ST APT E1",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476920",
            "telephone_number": "212-562-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MARCELA",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "114499-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Peterson, LCSW
• Kyle Victor Peterson, PA
• Lea Peterson, PA-C
• Louis John Peterson, DC
• Lydia Peterson, MSW
• Megan E Peterson, RPA
• Monte H Peterson, MD
• Nancy Peterson, PHD
• Paulette Peterson, PH.D.
• Powers Peterson, M.D.

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.