Individual provider · Type 1 NPI

Kristina Petersen

Clinical Social Worker · Bullhead City, AZ

NPI number 1104229806 Active

Practice location

2580 Hway 95 # 1250
Bullhead City, AZ 86442-7491

Fax (928) 763-7786

Mailing address

3450 N 3rd St
Phoenix, AZ 85012-2331

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X13439 (AZ)

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 1104229806

Kristina Petersen's National Provider Identifier is 1104229806, issued on Oct 8, 2014. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bullhead City, AZ. The record was last updated on Oct 8, 2014.