Jessica Peterson, LCSW
Social Worker, Clinical in Coeur D Alene, ID. Individual provider (NPI-1).
NPI number1669901260
StatusActive
Last updated in NPPESOct 12, 2023
Details
- NPI
- 1669901260
- Entity type
- Individual (NPI-1)
- Name
- Jessica Peterson
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2017
- Certification date
- Oct 12, 2023
- Last updated
- Oct 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCSW-39938 | ID | Yes |
Practice location
1044 Northwest Blvd Ste CCoeur D Alene, ID 83814-2114
Phone 208-930-1740 · Fax 208-930-1695
Mailing address
1044 Northwest Blvd Ste CCoeur D Alene, ID 83814-2114
Phone 208-930-1740 · Fax 208-930-1695
Other practice locations
1038 Northwest Blvd
Coeur D Alene, ID 83814-2249
Coeur D Alene, ID 83814-2249
Phone 208-930-1740 · Fax 208-930-1695
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