Elizabeth Morrison Petegorsky, LICSW CEAP LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1015429 Issued in MA

Practice address

19 Center CT
Suite 2a
Northampton, MA 01060-3006

Phone

(413) 297-5644

Fax

(413) 584-9915

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Ms. Elizabeth D Morrison Former name

Medicare fee-for-service enrollment

Enrolled in MA

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, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1972569325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 NORTH FARMS ROAD",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "01062",
            "telephone_number": "413-584-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CENTER CT",
            "address_2": "SUITE 2A",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603006",
            "telephone_number": "413-297-5644",
            "fax_number": "413-584-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETEGORSKY",
        "first_name": "ELIZABETH",
        "middle_name": "MORRISON",
        "name_prefix": "Ms.",
        "credential": "LICSW CEAP LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1135",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1015429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P04900",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "56264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OUT OF STATE",
            "identifier": "P04900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "56264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "35392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH E",
            "identifier": "56264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MORRISON",
            "middle_name": "D",
            "prefix": "MS.",
            "credential": "LICSW CEAP LADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Matthew Pepin
• Melanie Pepper, LAC
• Marlon Perez
• Michael Sholom Perlman, MD
• Norman S. Perr, MD
• Alexandra R Peterson, M.A.
• Katherine Sloane Peterson
• Kristin Peterson, LICSW
• Molly Peterson
• Karen Pettinelli

• Clinical Social Worker in Northampton, MA
• Providers in Northampton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.