Individual provider · Type 1 NPI

Shanice Nicole Peterson, LCSW

Clinical Social Worker · San Diego, CA

NPI number 1861037145 Active

Practice location

1620 5th Ave Ste 800
San Diego, CA 92101-2792

Call (619) 391-9665 Map

Mailing address

13087 Olympus Cir Unit 1
Poway, CA 92064-4677

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XLG50082715 (DC)
Clinical Social Worker Primary 1041C0700X134858 (CA)

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 1861037145

Shanice Nicole Peterson, LCSW's National Provider Identifier is 1861037145, issued on Nov 11, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in San Diego, CA. The record was last updated on Feb 22, 2026.