Individual provider · Type 1 NPI

Rebecca Lee Petersen

Clinical Social Worker · Madison, CT

NPI number 1124352174 Active

Practice location

147 Durham Rd, Oak Park
Madison, CT 06443-2675

Call (860) 227-6839 Map

Fax (860) 227-6839

Mailing address

1 Vaccinium Way
Old Lyme, CT 06371-2809

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X008697 (CT)

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 1124352174

Rebecca Lee Petersen's National Provider Identifier is 1124352174, issued on Sep 23, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Madison, CT. The record was last updated on Dec 3, 2014.