Individual provider · Type 1 NPI

Elishama Petersen

Clinical Social Worker · Wynantskill, NY

NPI number 1003682287 Active

Practice location

614 Cooper Hill Rd
Wynantskill, NY 12198-2906

Call (518) 283-6500 Map

Mailing address

PO Box 219
Wynantskill, NY 12198-0219

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: 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 interpers…

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About NPI 1003682287

Elishama Petersen's National Provider Identifier is 1003682287, issued on Nov 29, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Wynantskill, NY. The record was last updated on Nov 29, 2023.