Lael R Petersen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3614 Issued in OR

Practice address

1980 Willamette Falls Dr
Suite 240
West Linn, OR 97068-4668

Phone

(503) 656-2888

Fax

(503) 656-2282

NPI assigned

Jan 17, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Vanessa L. Owen, MSW, LCSW

  • Clinical Social Worker
  • West Linn, OR
  • NPI 1861778920
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962554139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 WILLAMETTE FALLS DR",
            "address_2": "SUITE 240",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970684668",
            "telephone_number": "503-656-2888",
            "fax_number": "503-656-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 WILLAMETTE FALLS DR",
            "address_2": "SUITE 240",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970684668",
            "telephone_number": "503-656-2888",
            "fax_number": "503-656-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LAEL",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Dentistry of West Linn
• Jorge Luis Perez Jr
• Elizabeth M Perkins, PHARM. D.
• Heidi Peters, M.A., CCC-SLP
• Jeanie Elizabeth Petersen
• Rita Petersen
• Gerald Dudley Peterson, DPM
• Benjamin Pham, DMD
• Linda Pham, L.M.T.
• Lynne Christine Piazza-Vitek, LMT

• Clinical Social Worker in West Linn, OR
• Providers in West Linn, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.