Individual provider · Type 1 NPI
Roger A. Pederson, LCSW
Counselor · Elkhart, IN
NPI number
1912906058
Active
Practice location
307 S Main St, Suite 305
Elkhart, IN 46516-3102
Fax (574) 296-7560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | 34001185A (IN) |
Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Another provider at this address
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About NPI 1912906058
Roger A. Pederson, LCSW's National Provider Identifier is 1912906058, issued on Jul 20, 2005. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Elkhart, IN. The record was last updated on Jul 8, 2007.