MARY L PETERSON (NPI# 1306813548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306813548 |
| Entity Type | Individual |
| Full Name | MARY L PETERSON |
| Credential | MSW ACSW |
| Practice Address |
2040 Raybrook Se Suite 103 Grand Rapids MI 49546 |
| Mailing Address |
2040 Raybrook St Se Suite 103 Grand Rapids MI 49546-7718 |
| Practice Telephone | 6169428060 |
| Practice Fax Number | 6169426690 |
| Mailing Telephone | 6169428060 |
| Mailing Fax Number | 6169426690 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801074847 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093314908 | Mary Jane Peterson | Chore Provider | 1126 Marianna Dr, Mansfield, OH 44903-9672 | 2020-10-21 |
| 1265963813 | Mary Peterson | Counselor | 221 Loesch Dr, Elgin, TX 78621-1101 | 2017-03-24 |
| 1598179434 | Mary Kathryn Peterson | Physical Therapist | 4690 Whipple Rd, Riverside, CA 92506-1066 | 2014-06-18 |
| 1356508675 | Mary Kathryn Peterson | Family Medicine | 205 S Northwest Hwy Ste 130, Park Ridge, IL 60068-5802 | 2008-05-22 |
| 1457564916 | Mary Beth Peterson | Pharmacist | Hy-vee Drugstore #7026, 2001 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402 | 2007-05-08 |
| 1942429873 | Mary Ann Peterson | Physical Therapist | 2117 General Booth Blvd, Virginia Beach, VA 23454-5803 | 2007-04-25 |
| 1538233176 | Mary Peterson | Chiropractor | 7250 W College Dr, Suite 1sw, Palos Heights, IL 60463-1151 | 2006-11-17 |
| 1083621445 | Mary E Peterson | Nurse Practitioner | W12070 State Highway 35, Stockholm, WI 54769-6127 | 2006-08-01 |
| 1174572846 | Mary E. Peterson | Psychiatry & Neurology | 105 W 8th Ave Ste 6055, Spokane, WA 99204-2312 | 2006-05-09 |
| 1346216678 | Mary C Peterson | Physical Therapist | 756 Ridge Lake Blvd, Ste 205, Memphis, TN 38120-9445 | 2006-02-27 |
| Street Address |
2040 RAYBROOK SE SUITE 103 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639560 | Ananya Avinash | Social Worker | 235 Olivia Ct Nw, Grand Rapids, MI 49504-5897 | 2020-11-03 |
| 1982203485 | Becoming You Therapy Pllc | Social Worker | 2346 Mission Hills Dr Se, Grand Rapids, MI 49546-7804 | 2020-10-26 |
| 1235738774 | Huffman Counseling Services LLC | Social Worker | 1950 Waldorf St Nw Ste E, Grand Rapids, MI 49544-1488 | 2020-10-24 |
| 1730795816 | Elizabeth Anne Maher | Social Worker | 1519 Pontiac Rd Se, Grand Rapids, MI 49506-3367 | 2020-09-23 |
| 1437764511 | Titiana Shanee Richardson | Social Worker | 113 Lake Michigan Drive Northwest, Grand Rapids, MI 49544 | 2020-09-15 |
| 1205448834 | Rose Training & Education, LLC | Social Worker | 156 Hillview Ave Ne, Grand Rapids, MI 49503-3824 | 2020-08-17 |
| 1497366967 | Krista L. Leinberger, LLC | Social Worker | 548 Fairview Ave Ne Apt 1, Grand Rapids, MI 49503-2581 | 2020-08-10 |
| 1609493782 | Lauren Anne Tarkiewicz | Social Worker | 700 Alger St Se, Grand Rapids, MI 49507-3531 | 2020-07-06 |
| 1841814779 | Molly Ballantyne | Social Worker | 1166 Hall St Se, Grand Rapids, MI 49507-1971 | 2020-06-06 |
| 1942839238 | Patricia Hickey Msw | Social Worker | 2020 Raybrook St Se Ste 301, Grand Rapids, MI 49546-7717 | 2020-04-07 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on MARY L PETERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.