MS. CAROL ANN PETERSON (NPI# 1942466677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942466677 |
| Entity Type | Individual |
| Full Name | MS. CAROL ANN PETERSON |
| Other Name | CAROL PETERSON-KOENIG |
| Credential | LCSW |
| Practice Address |
6605 W Burnside Rd #122 Portland OR 97210-6625 |
| Practice Telephone | 5032484010 |
| Mailing Telephone | 5032484010 |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-09-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1073 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730414012 | Carol A Peterson | Health Educator | 2465 Clark Rd, Erie, PA 16510-4411 | 2009-10-05 |
| 1538289004 | Carol Peterson | Technician | 4528 N Market St, Saint Louis, MO 63113-2113 | 2007-03-30 |
| 1518098003 | Carol Lynn Peterson | Physical Therapist | 2513 Huntingdon Chase, Atlanta, GA 30350-4964 | 2007-03-08 |
| 1295775377 | Carol M Peterson | Chiropractor | 2228 Turk Rd, Doylestown, PA 18901 | 2006-06-07 |
| 1629056080 | Carol B Peterson | Psychologist | 7400 New La Grange Rd, Ste 312, Louisville, KY 40222-4870 | 2006-01-05 |
| 1447723077 | Carol L Peterson | Speech-Language Pathologist | 700 Glasgow St, Cambridge, MD 21613-1738 | 2019-01-07 |
| 1255858510 | Carol Camille Peterson | Counselor | 505 S 12th Ave W, Virginia, MN 55792-3099 | 2017-08-28 |
| 1467744870 | Carol Jeanne Peterson | Genetic Counselor, MS | 500 Red Creek Dr, Suite 220, Rochester, NY 14623-4284 | 2011-05-04 |
| 1023309804 | Carol Jean Peterson | Nurse Practitioner | 744 S Webster Ave, Green Bay, WI 54301-3505 | 2011-04-27 |
| 1225354863 | Carol Peterson | Massage Therapist | 209 N Main St, Andover, MA 01810-3116 | 2010-04-07 |
| Street Address |
6605 W BURNSIDE RD #122 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-6625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| 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 |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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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.