Heather A Peterson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

101 21St Street SE
Austin, MN 55912

Phone

(507) 437-6389

Fax

(507) 437-0977

NPI assigned

Aug 1, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Management Services of MN, Inc.Group PAC ID 1658674775, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Independent Management Services of MN, Inc.

  • Community/Behavioral Health Agency
  • Austin, MN
  • NPI 1255472957
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1841844396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 21ST STREET SE",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "55912",
            "telephone_number": "507-437-6389",
            "fax_number": "507-437-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 21ST STREET SE",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "55912",
            "telephone_number": "507-437-6389",
            "fax_number": "507-437-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Austin",
            "affiliation": "N",
            "endpointDescription": "Business",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 21st street SE",
            "city": "Austin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colin Patterson
• Caitlin Teresa Pederson, PHARMD
• Liyanage Ashanthi Menaka Perera, M.D.
• Julie Ann Peters, PSYD, LP
• Stacy Petersen
• Kristen Rae Petterson, CNP
• Julianna Phatame
• Ruth Ann Pickering, D.O.
• Steven Pittelko
• Samantha Jo Plaehn, OTR/L

• Clinical Social Worker in Austin, MN
• Providers in Austin, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.