SAMANTHA JO PETERSEN APSW
NPI 1043101991
Social Worker in Menasha, WI

Q: What is Samantha Petersen's NPI number?

The NPI number for Samantha Petersen is 1043101991. It was assigned to this individual provider in the NPPES registry on July 10, 2025. The provider is also known as Samantha Jo Julius.

Q: What is Samantha Petersen's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Petersen was last updated on July 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since July 10, 2025PECOS Enrolled

1095 MIDWAY RD, MENASHA, WI 54952(920) 720-2300 Get Directions Write a Review

NPPES record last updated: July 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Samantha Jo Petersen Apsw NPPES

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

SAMANTHA JO PETERSEN APSW (NPI 1043101991) is an individual social worker in Menasha, Wisconsin, licensed in Wisconsin (135619-121) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1043101991

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameSAMANTHA JO PETERSENCredential: APSW

Location Address1095 MIDWAY RDMenasha, WI 54952-1115

Mailing Address1095 Midway RdMenasha, WI 54952-1115

Phone(920) 720-2300

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJuly 10, 2025

NPPES CertifiedJuly 10, 2025

✔ NPI 1043101991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in WI · 135619-121

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

1095 MIDWAY RD, Menasha, WI 54952

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Other Names 1

Former Name (1)Samantha Jo Julius

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Jo Petersen Apsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4486152097

PECOS Enrollment IDI20250813000364

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

DARLENE LEARY

Counselor (Addiction (Substance Use Disorder))