Jennifer L Peterson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JENNIFER L PETERSON

Practice address

2204 Petersen Dr NW
Stewartville, MN 55976-1680

Phone

(507) 316-2001

NPI assigned

Feb 24, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Lynn Peterson, LICSW

Title

Licensedmental Health Professional

Phone

(507) 316-2001

Specialties & licenses 1

Addresses

Other names 1

• ZENOVA Therapy Other name

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1871292268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PETERSEN DR NW",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559761680",
            "telephone_number": "507-316-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PETERSEN DR NW",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559761680",
            "telephone_number": "507-316-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER L PETERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "LICENSEDMENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "507-316-2001",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZENOVA Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Huelskamp Chiropractic Clinic, P.a.
• Kevin William Huelskamp, DC
• Hy-Vee Inc
• Ind School Dist 534
• Isd #534 Stewartville Public Schools
• Leroy Johnson Jr.
• Jeremy Krekula
• Michael George Kuderer, D.C.
• Zachary John Lechner, D.D.S.
• Stephanie Christine Lillis, D.C.

• Clinical Social Worker in Stewartville, MN
• Providers in Stewartville, 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 Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.