National Provider Identifier

Stephanie Elizabeth Petersen, L.M.S.W.

Stephanie Elizabeth Petersen, L.M.S.W. is listed in the NPPES registry with a primary specialty of Social Worker in Palmyra, NY and a listed phone number of (315) 569-3053.

NPI 1487269759Palmyra, NYSocial Worker

Profile Overview

NPI
1487269759
Provider Type
Individual
Primary Specialty
Social Worker
Enumeration Date
September 13, 2020
Last Updated
September 13, 2020

Practice Location

  • 153 Salzburg Vlg
  • Palmyra, NY 14522-1343

Phone: (315) 569-3053

Specialties

  • Social Worker (104100000X)
Full Record
NPI
1487269759
Entity Type
Individual
Last Name
Petersen
First Name
Stephanie
Middle Name
Elizabeth
Credential
L.M.S.W.
Mailing Street Address
153 Salzburg Vlg
Mailing City
Palmyra
Mailing State
NY
Mailing ZIP Code
14522-1343
Mailing Country
US
Mailing Phone
(315) 569-3053
Practice Street Address
153 Salzburg Vlg
Practice City
Palmyra
Practice State
NY
Practice ZIP Code
14522-1343
Practice Country
US
Practice Phone
(315) 569-3053
Enumeration Date
September 13, 2020
Last Updated
September 13, 2020
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
September 13, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Social Worker (104100000X)