MR. TYLER ROLLAND PETERSEN (NPI# 1770960452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770960452 |
| Entity Type | Individual |
| Full Name | MR. TYLER ROLLAND PETERSEN |
| Credential | CSW |
| Practice Address |
13351 S Shaunna Lane Herriman UT 84096 |
| Mailing Address |
13351 S Shaunna Ln Herriman UT 84096-4706 |
| Practice Telephone | 8019156055 |
| Mailing Telephone | 8019156055 |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
5919098-3502 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093102220 | Tyler Daniel Petersen | Orthopaedic Surgery | 3600 Nw Samaritan Dr, Corvallis, OR 97330-3737 | 2015-04-26 |
| Street Address |
13351 S SHAUNNA LANE |
| City | HERRIMAN |
| State | UT |
| Zip Code | 84096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1225563703 | Kristen Haslam | Specialist/Technologist, Other | 13947 S Newburg Dr., Herriman, UT 84096 | 2017-04-21 |
| 1649687948 | Victor Clark | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096 | 2014-07-18 |
| 1548539554 | Neck and Back Relief | Chiropractor | 12600 S. 4013 W., Suite E, Riverton, UT 84096 | 2011-12-20 |
| 1114220092 | Sharlene Christensen | Counselor | 13878 S. Ken Cv, Herriman, UT 84096 | 2010-12-14 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1215154232 | Karen Jane Olson | Nurse Practitioner | 13400 S. 5746 W #200, Herriman, UT 84096 | 2007-04-19 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1578638854 | Stevenson Pediatric Dentistry P.C. | Dentist | 4019 W. 12600 S., Suite 200, Riverton, UT 84096 | 2006-11-21 |
| 1730278946 | Rebecca Mostatab | Dentist | 4531 W Partridgehill Lane, Suite F-110, Riverton, UT 84096 | 2006-10-12 |
| Find all providers in zip 84096 | ||||
| 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 |
|---|---|---|---|---|
| 1053889501 | Jacob K Vickrey | Social Worker | 4468 W Breezy Meadow Dr, Herriman, UT 84096-7492 | 2018-11-02 |
| 1255881215 | Julie Madsen | Social Worker | 5627 W 13100 S Ste B, Herriman, UT 84096-6921 | 2016-10-13 |
| 1871916742 | Darren Micheal Dautel | Social Worker | 13981 S Barneys Peak Cir, Herriman, UT 84096-1903 | 2014-01-29 |
| 1255638417 | Candice Lynn Adair | Social Worker | 5719 W Plow Ln, 9405, Herriman, UT 84096-5556 | 2011-02-23 |
| 1962696930 | Michael Joel Hoglund | Social Worker | 13351 S 7300 W, Herriman, Herriman, UT 84096-4671 | 2007-08-31 |
| 1043829401 | Brittany Bitters | Social Worker | 5629 W 13100 S, Herriman, UT 84096-6921 | 2020-07-30 |
| 1962997924 | Jenni Anne Marchant | Social Worker | 5627 W 13100 S Ste B, Herriman, UT 84096-6921 | 2018-06-22 |
| 1891225249 | Herriman Counseling Services, LLC | Social Worker | 5627 W 13100 S Ste B, Herriman, UT 84096-6921 | 2017-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619194 | Patricia Collette Johnson | Social Worker | 11075 S State St # 32, Sandy, UT 84070-5164 | 2020-11-05 |
| 1124629597 | Jessica Aimee Furner | Social Worker | 3740 W Market Center Dr Ste 12, Bluffdale, UT 84065-8026 | 2020-11-03 |
| 1679172217 | Restoring Balance Therapy Services, LLC | Social Worker | 20 W Main Street Ct Ste 200, Alpine, UT 84004-1889 | 2020-10-24 |
| 1174122303 | Rachel Ellen Allred | Social Worker | 128 N 100 W Ste 5, Price, UT 84501-2429 | 2020-10-19 |
| 1053910331 | Mount Olympus Counseling Center, Inc. | Social Worker | 4525 S 2300 E Ste 102, Holladay, UT 84117-4682 | 2020-10-19 |
| 1922606763 | Eric Jeffrey Hales | Social Worker | 352 S Denver St Ste 350, Salt Lake City, UT 84111-3059 | 2020-10-14 |
| 1639777568 | Megan Komatsu Inc. | Social Worker | 10815 700 East, Sandy, UT 84070 | 2020-10-13 |
| 1801493382 | Maxwell Marshall Mount | Social Worker | 249 Rodeo Dr, Springville, UT 84663-9472 | 2020-10-07 |
| 1720685571 | Better Options Counseling LLC | Social Worker | 3450 E Barrel Roll Dr, Saint George, UT 84790-5045 | 2020-10-05 |
| 1659986917 | Alliance Counseling Pllc | Social Worker | 352 S Denver St # 215, Slc, UT 84111-3000 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
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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.