Individual provider · Type 1 NPI

Sandra Luann Peterson, LICSW

Clinical Social Worker · Thief River Falls, MN

NPI number 1053307025 Active

Practice location

120 Labree Ave S, Northwest Medical Center
Thief River Falls, MN 56701-2819

Call (218) 681-4240 Map

Fax (218) 681-5614

Mailing address

21078 115th Ave NE
Thief River Falls, MN 56701-9313

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X4847 (MN)

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 1053307025

Sandra Luann Peterson, LICSW's National Provider Identifier is 1053307025, issued on Sep 23, 2005. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Thief River Falls, MN. The record was last updated on Jul 13, 2026.