MARY LORRAINE PETERSEN (NPI# 1710083084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710083084 |
| Entity Type | Individual |
| Full Name | MARY LORRAINE PETERSEN |
| Credential | LCSW |
| Practice Address |
705 Hilltop Ct Coram NY 11727 |
| Practice Telephone | 6316964355 |
| Mailing Telephone | 6319889812 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
R023294 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427614270 | Mary Jane Petersen | Physical Therapist | 710 Mound Ave, Mankato, MN 56001-1600 | 2019-05-17 |
| 1417306267 | Mary Petersen | Counselor | 13561 Lakes Way, Orlando, FL 32828-8154 | 2016-06-11 |
| 1629467048 | Mary Petersen | Social Worker | 1430 Wilkins Cir, Casper, WY 82601-1336 | 2015-01-22 |
| 1609176163 | Mary Janeen Petersen | Pharmacist | 4495 First St, Livermore, CA 94551-4915 | 2010-10-29 |
| 1063661916 | Mary Alice Petersen | Speech-Language Pathologist | 104 Stampede St, Newcastle, WY 82701-3037 | 2008-09-16 |
| 1003986068 | Mary Petersen | Social Worker | 58144 Gratiot Ave, New Haven, MI 48048 | 2006-11-08 |
| 1114938016 | Mary Elizabeth Petersen | Speech-Language Pathologist | 10701 East Blvd, Audiology and Speech Pathology 126 W, Cleveland, OH 44106-1702 | 2006-08-10 |
| Street Address |
705 HILLTOP CT |
| City | CORAM |
| State | NY |
| Zip Code | 11727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568892214 | Mary Lorraine Petersen, Csw PC | Social Worker | 705 Hilltop Ct, Coram, NY 11727-3640 | 2013-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649891490 | Ocean Acupuncture PC | Acupuncturist | 1970-6, Coram, NY 11727 | 2020-05-04 |
| 1982254058 | Lynanne Helen Bopp | Student in an Organized Health Care Education/Training Program | 3600 Ny- 112, Coram, NY 11727 | 2019-09-19 |
| 1427604206 | Embrace Your Energy, LLC | Specialist/Technologist | 300 Wincoram Way, Coram, NY 11727 | 2019-08-16 |
| 1457842247 | Hina Ghani | Pharmacist | 1710 Ny-112, Coram, NY 11727 | 2018-05-29 |
| 1093219636 | James Brian Rochford Jr. | Social Worker | 1980 Ny Route 112, Coram, NY 11727 | 2018-03-20 |
| 1902324502 | Shanell Lovette Woodley | Registered Nurse | Country Club Drive, Apt 10 D, Coram, NY 11727 | 2017-09-03 |
| 1730606377 | Emani, Inc. | Respite Care | 5 Hagen Ct., Coram, NY 11727 | 2017-08-24 |
| 1124553292 | Zhimin Lin | Dentist | 1879 Ny-112, Coram, NY 11727 | 2017-04-26 |
| 1780125286 | Jennifer Zielinski | Specialist | 18 Cammann Road, Coram, NY 11727 | 2017-03-16 |
| 1194271486 | Kimberly Kowalczyk | Psychologist | 28 Hawkins Path, Coram, NY 11727 | 2016-08-28 |
| Find all providers in zip 11727 | ||||
| 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 |
|---|---|---|---|---|
| 1790316982 | Zarie Sedigh | Social Worker | 14 Yosemite Ln, Coram, NY 11727-2060 | 2020-01-28 |
| 1780238725 | Ellen Gordon | Social Worker | 1844 Route 112 Ste A, Coram, NY 11727-2337 | 2019-07-29 |
| 1265969257 | Joseph Illovsky | Social Worker | 34 Teller Ave, Coram, NY 11727-4042 | 2017-05-22 |
| 1659759892 | Charles Eisenberg | Social Worker | 141 Birchwood Rd, Coram, NY 11727-3675 | 2015-05-07 |
| 1043646995 | Debbie Gross | Social Worker | 4 Otter Path, Coram, NY 11727-2148 | 2013-09-24 |
| 1306192257 | Valerie Hunter-king | Social Worker | 7 Carnaby Ave, Coram, NY 11727-1711 | 2012-07-30 |
| 1629375357 | Julie Anna Weinheimer | Social Worker | 8 Idaho Ct, Coram, NY 11727-1511 | 2011-02-15 |
| 1750435665 | Aytac Aydogan Edwards | Social Worker | 1 Lake Placid Ct, Coram, NY 11727-2022 | 2007-01-22 |
| 1497804652 | Laura E Grossman | Social Worker | 11 Wren Lane, Coram, NY 11727-2727 | 2007-01-09 |
| 1861540940 | Howard Jeffrey Riesel | Social Worker | 1 Barone Dr, Coram, NY 11727-3082 | 2007-01-08 |
| Find all providers in CORAM | ||||
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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.