Robert John Peterson, LICSW

Clinical Social Worker · Loon Lake, WA

Individual Active NPI

NPI number 1922336684

Practice location

40647 Lake Rd
Loon Lake, WA 99148-9795
Phone
(509) 939-5515

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NPI record

NPI
1922336684
Entity type
Individual (Type 1)
Enumeration date
November 18, 2009
Last updated
November 9, 2023
Certified
November 9, 2023
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 60174553 WA
Social Worker 104100000X X-06759 NM

Other practice locations (1)

  • 200 Center St, Moriarty, NM 87035-2000 · (505) 832-5817

About Robert Peterson

Robert John Peterson, LICSW is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 40647 Lake Rd, Loon Lake, WA 99148-9795. The NPI number 1922336684 was assigned on November 18, 2009 and the record was last updated on November 9, 2023.

Robert Peterson lists 2 licenses in the registry: #60174553 (WA) for Clinical Social Worker; #X-06759 (NM) for Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Robert John Peterson, LICSW?

The NPI number is 1922336684.

What is the phone number of Robert Peterson?

The phone number listed for the practice location is (509) 939-5515.

Where is Robert Peterson located?

40647 Lake Rd, Loon Lake, WA 99148-9795.

What is the taxonomy code for Robert Peterson?

The primary taxonomy code is 1041C0700X – Clinical Social Worker; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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