Stephanie Petersen, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1800806 Issued in OH

Practice address

55 Arch St Ste 1B
Akron, OH 44304-1436

Phone

(330) 375-3315

Fax

(330) 375-3760

NPI assigned

Feb 19, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• 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

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.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  Clinical

  Medicare reassignment NPD
• Summa Physicians LLC

  • Obstetrics & Gynecology Physician
  • Akron, OH
  • NPI 1235167719
  NPD

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1902306616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GORGE BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102408",
            "telephone_number": "234-312-5691",
            "fax_number": "234-312-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ARCH ST STE 1B",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041436",
            "telephone_number": "330-375-3315",
            "fax_number": "330-375-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "STEPHANIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292661",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenna Peters, RD,LD
• Michelle Marie Peters, RN
• Patricia Peters
• Tara Peters, MSW, LISW-S
• Tyler Joel Peters, PA-C
• Geoffrey Alan Peterson, M.D.
• Gregory A Peterson, MD
• Kalyn Peterson, DO
• Kathy J Peterson, P.T.
• Sara Elizabeth Peterson, MD

• Clinical Social Worker in Akron, OH
• Providers in Akron, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.