Gretchen Elsa Peterson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10239 Issued in MN

Practice address

3395 Plymouth Rd
Minnetonka, MN 55305

Phone

(952) 939-0396

Fax

(952) 548-8760

NPI assigned

Apr 17, 2018

Sex

Female

Sole proprietor

No

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 29, 2018.

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1982191847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053765",
            "telephone_number": "952-939-0396",
            "fax_number": "952-548-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-939-0396",
            "fax_number": "952-548-8760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8800 Highway 7 Ste 200",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554263955",
            "country_code": "US",
            "telephone_number": "952-939-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GRETCHEN",
        "middle_name": "ELSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Joseph Perszyk, OD
• Perzhu Construction LLC
• Ariana Peterson, OTR
• Caitlin Marie Peterson
• Debra J Peterson, RN, CFNP
• Kathleen Marie Frischmann Peterson, PSYD, LP
• Sieglinde Iris Peterson, M.D.
• Melissa Ann Petoletti, MS, LPCC, LADC
• Mary Petruzzi, APRN
• Laura Marie Pett, MA CCC A

• All providers in Minnetonka, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.