Individual provider · Type 1 NPI

Diane Petersen, LCSW

Clinical Social Worker · Grayslake, IL

NPI number 1306187117 Active

Practice location

18640 W Il Route 120
Grayslake, IL 60030-9733

Call (847) 548-6000 Map

Fax (847) 548-6040

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149.005019 (IL)

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 1306187117

Diane Petersen, LCSW's National Provider Identifier is 1306187117, issued on Mar 5, 2013. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grayslake, IL. The record was last updated on Mar 5, 2013.