Jolene Peterson is a Clinical in Rapid City, South Dakota. Jolene Peterson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jolene Peterson is 1033173349. The last update date is 2022-04-11.
Jolene Peterson's current location address is 3200 Canyon Lake Dr, Rapid City, South Dakota. You can contact this provider via phone number 6053552215 and fax number 6053552504. The mailing address for Jolene Peterson is 3200 Canyon Lake Dr, Rapid City, South Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jolene Peterson |
|---|---|
| Address | 3200 Canyon Lake Dr, Rapid City, South Dakota |
| Phone Number | 6053552215 |
| Fax Number | 6053552504 |
| Sole Proprietor | N |
| Credentials | MSW LCSW P |
NPI Number Detail
| NPI Number | 1033173349 |
|---|---|
| Provider Enumeration Date | 2006-04-13 |
| Last Updated Date | 2022-04-11 |
Provider Mailing Address Detail
| Address | 3200 Canyon Lake Dr |
|---|---|
| City | Rapid City |
| State | South Dakota (SD) |
| Post Code | 577028114 |
| Phone Number | 6053552215 |
| Fax Number | 6053552504 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1265 |
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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 |
|---|---|---|---|
| 554090 | SD | -- |
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What is the unique 10-digit identifier code issued to Jolene Peterson by the Centers for Medicare & Medicaid Services?
The Jolene Peterson has been assigned the NPI (National Provider Identifier) 1033173349 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Jolene Peterson located?
The Jolene Peterson is located at 3200 Canyon Lake Dr, Rapid City, SD 577028114.
What is Jolene Peterson's area of expertise and its corresponding taxonomy classification?
The Jolene Peterson's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Jolene Peterson receive the assignment of its 1033173349 from the Centers for Medicare & Medicaid Services?
The Jolene Peterson was issued its 1033173349 by the Centers for Medicare & Medicaid Services on 2006-04-13.
When was the information regarding Jolene Peterson most recently updated?
The details pertaining to the Jolene Peterson, including its address, specialty, and other relevant information, were last refreshed on 2022-04-11.
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