SCOTT JEFFREY PETERSON (NPI# 1457917627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457917627 |
| Entity Type | Individual |
| Full Name | SCOTT JEFFREY PETERSON |
| Practice Address |
3300 36th St Se Grand Rapids MI 49512-2810 |
| Mailing Address |
1638 Rose Pkwy Se Grand Rapids MI 49506-5247 |
| Practice Telephone | 6169422110 |
| Mailing Telephone | 6165819907 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 6801104299 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801436787 | Scott Kermit Peterson | Registered Nurse | 30681 Olson St Apt 2, Pequot Lakes, MN 56472-3081 | 2020-01-08 |
| 1619413093 | Scott T Peterson | Dentist | 5235 W Baseline Rd, #187, Laveen, AZ 85339-3122 | 2017-01-10 |
| 1427202266 | Scott Andrew Peterson | Social Worker | 2000 Dry Valley Road, Loa, UT 84747 | 2008-11-06 |
| 1336398783 | Scott Allen Peterson | Occupational Therapist | 8765 Blue Pine Way, Reno, NV 89523-3843 | 2008-09-10 |
| 1013034842 | Scott L. Peterson | Counselor | 11011 S 48th St Ste 200, Phoenix, AZ 85044-1788 | 2007-03-25 |
| 1033126974 | Scott Michael Peterson | Specialist/Technologist | Lemoyne College Sports Medicine, 1419 Salt Springs Road, Syracuse, NY 13214-1399 | 2006-08-02 |
| 1750351441 | Scott David Peterson | Optometrist | 3988 Washington Blvd, Ogden, UT 84403-1826 | 2006-01-25 |
| 1649250242 | Scott M Peterson | Obstetrics & Gynecology | 3300 W Centre Ave, Bronson Ob Gyn Associates, Portage, MI 49024-4666 | 2006-01-19 |
| 1598121808 | Scott Peterson | Ophthalmology | 3777 Coon Rapids Blvd Nw Ste 100, Coon Rapids, MN 55433-2630 | 2016-01-04 |
| 1720492655 | Scott Peterson | Marriage & Family Therapist | 1880 River Rd, Grand Rapids, MN 55744-4085 | 2014-06-18 |
| Street Address |
3300 36TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49512-2810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215047667 | Wedgwood Christian Services | Community/Behavioral Health | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2006-08-30 |
| 1396345005 | Khrystal Lewis | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-10-30 |
| 1528675105 | Aleah Caizza | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-28 |
| 1356958144 | Joyce Marie Mason | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-25 |
| 1689280638 | Aaron Jeremy Ackley | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-16 |
| 1588270417 | Hayley Landstra | Behavior Technician | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-09-16 |
| 1972114288 | Ashley Pecott | Counselor | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-11 |
| 1376154856 | Zorica Baka | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-10 |
| 1588274336 | Jenna Beson | Student in an Organized Health Care Education/Training Program | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-06 |
| 1821608795 | Evan Helene Pellow-robbins | Social Worker | 3300 36th St Se, Grand Rapids, MI 49512-2810 | 2020-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1013147495 | Ardean Beth Brock-vanderwall | Counselor | 2828 Kraft Ave., Grand Rapids, MI 49512 | 2009-07-20 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173595 | Laura Ann Dillivan | Social Worker | 1545 Cole Ave Ne, Grand Rapids, MI 49505-5026 | 2020-10-29 |
| 1912510033 | Alexandra Burke Hagerty | Social Worker | 1047 Wealthy St Se, Grand Rapids, MI 49506-1551 | 2020-08-28 |
| 1124643689 | Lavange Barth LLC | Social Worker | 400 Monroe Ave Nw Ste 400, Grand Rapids, MI 49503-1476 | 2020-06-10 |
| 1962026641 | Maya Louise Williams | Social Worker | 1101 Ball Ave Ne Bldg D, Grand Rapids, MI 49505-5904 | 2020-05-29 |
| 1720618242 | Terri Lynn Ingram | Social Worker | 1030 Sunrise Ln Nw, Grand Rapids, MI 49534-3679 | 2020-01-23 |
| 1528698206 | Kristen Zolen | Social Worker | 3310 Eagle Park Dr Ne, Grand Rapids, MI 49525-4574 | 2020-01-22 |
| 1437789120 | Ann Louise Przybysz | Social Worker | 3310 Eagle Park Dr Ne Ste 100, Grand Rapids, MI 49525-4574 | 2020-01-22 |
| 1649810276 | Dana Harrison | Social Worker | 500 Fulton St E Apt 303, Grand Rapids, MI 49503-4491 | 2020-01-12 |
| 1336781939 | Samantha L Klokkert | Social Worker | 2013 Eastcastle Dr Se Ste B, Grand Rapids, MI 49508-8873 | 2019-10-15 |
| 1952958191 | Morgan Fegel | Social Worker | 2040 E Beltline Ave Ne, Grand Rapids, MI 49525-9716 | 2019-08-22 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49512 |
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| 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.