Individual provider · Type 1 NPI

Jaclyn Annette Petersen, MSW

Clinical Social Worker · Champaign, IL

NPI number 1780273102 Active

Practice location

309 W Clark St
Champaign, IL 61820-4637

Call (217) 398-9066 Map

Fax (217) 398-9077

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149.022485 (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 1780273102

Jaclyn Annette Petersen, MSW's National Provider Identifier is 1780273102, issued on Jan 11, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Champaign, IL. The record was last updated on Jan 11, 2021.