Shirley Marie Petersen in Pine Ridge - Clinical
Shirley Marie Petersen - NPI 1740356336
Shirley Marie Petersen is a Clinical in Pine Ridge, South Dakota. Shirley Marie Petersen practices all healthcare services and medical treatments related to Clinical. The NPI Number for Shirley Marie Petersen is 1740356336. The last update date is 2012-06-25.
Shirley Marie Petersen's current location address is Highway 18, Pine Ridge, South Dakota. You can contact this provider via phone number 6058673100 and fax number 6058673274. The mailing address for Shirley Marie Petersen is Highway 18, Pine Ridge, South Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shirley Marie Petersen |
|---|---|
| Address | Highway 18, Pine Ridge, South Dakota |
| Phone Number | 6058673100 |
| Fax Number | 6058673274 |
| Sole Proprietor | Y |
| Credentials | LCSW LMHP |
NPI Number Detail
| NPI Number | 1740356336 |
|---|---|
| Provider Enumeration Date | 2006-11-27 |
| Last Updated Date | 2012-06-25 |
Provider Mailing Address Detail
| Address | Highway 18 |
|---|---|
| City | Pine Ridge |
| State | South Dakota (SD) |
| Post Code | 57770 |
| Phone Number | 6058673100 |
| Fax Number | 6058673274 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1043 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10025224900 | NE | -- | |
| 82235 | NE | BCBS | |
| 47037661202 | NE | -- | |
| 10025315600 | NE | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Shirley Marie Petersen by the Centers for Medicare & Medicaid Services?
The Shirley Marie Petersen has been issued the NPI (National Provider Identifier) 1740356336, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Shirley Marie Petersen is physically located?
The Shirley Marie Petersen is physically situated at the following address: Highway 18, Pine Ridge, SD, 57770.
What is the area of specialization for Shirley Marie Petersen, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Shirley Marie Petersen is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1740356336 to Shirley Marie Petersen?
The Shirley Marie Petersen received its 1740356336 assignment from the Centers for Medicare & Medicaid Services on 2006-11-27.
When was the information regarding Shirley Marie Petersen, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Shirley Marie Petersen, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2012-06-25.