JOHN PETERSON LISW, CDCA - NPI 1023464682 - Social Worker in Canton, OH

Q: What is John Peterson's NPI number?

The NPI number for John Peterson is 1023464682. It was assigned to this individual provider in the NPPES registry on May 12, 2016.

Q: What is John Peterson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for John Peterson was last updated on November 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

On this page

About John Peterson Lisw, Cdca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN PETERSON LISW, CDCA (NPI 1023464682) is an individual clinical provider in Canton, Ohio, licensed in Ohio (I1801316) and active in the NPI registry since May 2016. He maintains a secondary practice location in Canton.

NPPES Registry Identity

NPI1023464682

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameJOHN PETERSONCredential: LISW, CDCA

Location Address733 MARKET AVE SCanton, OH 44702-2165

Mailing Address1341 Market Ave NCanton, OH 44714-2605 · (330) 453-8252

Phone(330) 489-4600

Sole ProprietorNo

Enumeration DateMay 12, 2016

Last NPPES UpdateNovember 30, 20182 updates tracked since enumeration

✔ NPI 1023464682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in OH · I1801316

Definition

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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0012311 (OH), 011229 (OH)

733 MARKET AVE S, Canton, OH 44702

Open in Google Maps ↗

Secondary Practice Location 1

Location 11341 Market Ave NCanton, OH 44714-2605 · Phone (330) 453-8252

Other Identifiers 1

Medicaid2901131OH

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOLE MARIE ADY LPN

Licensed Practical Nurse