Lesley Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05578900 Issued in NJ

Practice address

270 Highway 35
Red Bank, NJ 07701-5920

Phone

(732) 842-2000

Fax

(732) 224-0688

NPI assigned

Dec 12, 2013

Last updated

Jun 15, 2016By the provider in NPPES

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 NJ

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifebulb LLCGroup PAC ID 2062881162, 97 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1861823056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 INDUSTRIAL WAY E",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243332",
            "telephone_number": "732-290-1700",
            "fax_number": "732-290-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015920",
            "telephone_number": "732-842-2000",
            "fax_number": "732-224-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LESLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05578900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perfect Smile Dental Office PC (the perfect smile)
• Alexandria Joy Persico, MOT, OTR/L
• Susana Pestana-Szwarc, MS
• Megan Petach, LCSW, LCADC, CCM
• Peter J. Litwin, MD, LLC
• John W Petrie
• Megan K Pfeifer, APRN
• Arthur H Phair, M.D.
• Carmen Rachael Phaneuf, NP
• Phillip J Mosca MD LLC

• Clinical Social Worker in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.