Neal Aaron Petersen, MSSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1680123 Issued in WI

Practice address

1315 W Main Street
Watertown, WI 53094

Phone

(920) 261-4100

Fax

(920) 261-8801

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Resources Associates Inc

  • Mental Health Counselor
  • Jefferson, WI
  • NPI 1497960645
  NPD (past)
• Family Resources Associates Inc

  • Mental Health Counselor
  • Watertown, WI
  • NPI 1831202621
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982612453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53094",
            "telephone_number": "920-261-4100",
            "fax_number": "920-261-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W MAIN STREET",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53094",
            "telephone_number": "920-261-4100",
            "fax_number": "920-261-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NEAL",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1680123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN INSURANCE",
            "identifier": "166358",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEON HEALTH INS",
            "identifier": "10056",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS INS",
            "identifier": "1011421",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY INSURANCE",
            "identifier": "39184249627",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39623200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY INSURANCE",
            "identifier": "39184249626",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Penn, COTA
• Bonnie Kay Peot, LPN
• Dena Ann Person, R.D.
• Petersen Chiropractic Office, S.C.
• Claire Niles Petersen, D.C.
• Allison M Pfaff, RD
• Philip M Marden MD SC
• Jacalyn Phillips, M.S. CCC-SLP
• Brittany Pollentier, PT
• Teresa Price

• Clinical Social Worker in Watertown, WI
• Providers in Watertown, WI by specialty
• Clinical Social Worker in Wisconsin

• 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.