Active NPI
Marlene M Peterson, LCSW
- Clinical Social Worker
- Pointblank, TX
National Provider Identifier
1861675902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12401
- Practice address
- 9951 US Highway 190 E
Pointblank, TX 77364-6896 - Phone
- (281) 851-1685
- NPI assigned
- Dec 12, 2007
- Last updated
- Apr 28, 2009
- Sex
- Female
- 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 | 12401 | TX | Primary |
Addresses
Primary practice location
9951 US Highway 190 E
Pointblank, TX 77364-6896
Mailing address
9951 US Highway 190 E
Pointblank, TX 77364-6896
Phone (281) 851-1685
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12401 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1861675902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9951 US HIGHWAY 190 E",
"city": "POINTBLANK",
"state": "TX",
"postal_code": "773646896",
"telephone_number": "281-851-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9951 US HIGHWAY 190 E",
"city": "POINTBLANK",
"state": "TX",
"postal_code": "773646896",
"telephone_number": "281-851-1685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MARLENE",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-12",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "12401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pointblank, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.