Individual provider · Type 1 NPI

Gordon Wayne Petersen, MSW, LICSW

Clinical Social Worker · Burlington, VT

NPI number 1487746244 Active

Practice location

166 Battery St
Burlington, VT 05401-5283

Call (802) 862-3373 Map

Mailing address

763 North Ave
Burlington, VT 05401-2728

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	089-0000142 (VT)

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 1487746244

Gordon Wayne Petersen, MSW, LICSW's National Provider Identifier is 1487746244, issued on Sep 29, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Burlington, VT. The record was last updated on Jul 8, 2007.