Individual provider · Type 1 NPI

Mary Lorraine Petersen, LCSW

Clinical Social Worker · Coram, NY

NPI number 1710083084 Active

Practice location

705 Hilltop Ct
Coram, NY 11727

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XR023294 (NY)

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 1710083084

Mary Lorraine Petersen, LCSW's National Provider Identifier is 1710083084, issued on Sep 15, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Coram, NY. The record was last updated on Jul 8, 2007.