Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SANDRA LUANN PETERSON LICSW
NPI 1053307025
Social Worker - Clinical in Thief River Falls, MN

Active since September 23, 2005
120 LABREE AVE S, NORTHWEST MEDICAL CENTER, THIEF RIVER FALLS, MN 56701(218) 681-4240(218) 681-5614 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sandra Luann Peterson Licsw NPPES

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

SANDRA LUANN PETERSON LICSW (NPI 1053307025) is an individual clinical provider in Thief River Falls, Minnesota, licensed in Minnesota (4847) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1053307025
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSANDRA LUANN PETERSONCredential: LICSW
Location Address120 LABREE AVE S, NORTHWEST MEDICAL CENTERThief River Falls, MN 56701-2819
Mailing Address21078 115th Ave NeThief River Falls, MN 56701-9313 · (218) 681-3658
Fax(218) 681-5614
Sole ProprietorNo
Enumeration DateSeptember 23, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1053307025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MN · 4847
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.
120 LABREE AVE S, Thief River Falls, MN 56701

Other Identifiers 2

Medicaid09493300MN
Other336L2PEMN · Bcbs

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.

Counselor (Addiction (Substance Use Disorder))
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Nurse Practitioner
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Speech-Language Pathologist
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Nurse Practitioner (Psychiatric/Mental Health)
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Pharmacy (Institutional Pharmacy)
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Psychologist (Clinical)
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701
Psychologist
120 LABREE AVE S
THIEF RIVER FALLS, MN 56701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandra Peterson's NPI number?

The NPI number for Sandra Peterson is 1053307025. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Sandra Peterson located?

Sandra Peterson practices at 120 Labree Ave S Northwest Medical Center, Thief River Falls, MN 56701. The listed phone number is (218) 681-4240.

What is Sandra Peterson's specialty?

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

When was this NPI record last updated?

The NPPES record for Sandra Peterson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days 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.