1. Home
  2. Directory
  3. Minnesota
  4. White Earth
  5. Social Worker
  6. NPI Profile

KRISTIN PETERSEN
NPI 1710422779
Social Worker - Clinical in White Earth, MN

Active since December 30, 2016PECOS Enrolled
26246 CRANE RD, WHITE EARTH, MN 56591(218) 983-4703 Get Directions Write a Review

NPPES record last updated: December 30, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kristin Petersen NPPES

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

KRISTIN PETERSEN (NPI 1710422779) is an individual clinical provider in White Earth, Minnesota, licensed in Minnesota (21218) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1710422779
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKRISTIN PETERSEN
Location Address26246 CRANE RDWhite Earth, MN 56591-9998
Mailing Address6578 Big Bass Rd NeBemidji, MN 56601-8674 · (218) 760-6543
Phone(218) 983-4703
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateDecember 30, 2016
✔ NPI 1710422779 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 · 21218
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.
26246 CRANE RD, White Earth, MN 56591
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID9537647763
PECOS Enrollment IDI20260129002976
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56591 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

WHITE EARTH BAND OF CHIPPEWA
Ambulance (Land Transport)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3285
WHITE EARTH BAND OF OJIBWE
Community/Behavioral Health
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3285
WHITE EARTH BAND OF CHIPPEWA
Community/Behavioral Health
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3286
GRANT JUSTIN ATWOOD MS, LPCC
Counselor (Mental Health)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-4703
SHANIA RENTSCHLER LPCC
Counselor (Mental Health)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-4703
WHITE EARTH BAND OF CHIPPEWA
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3286
SEAN SIMPSON LGSW
Social Worker (Clinical)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3286
MRS. SARAH JANE JASKEN M.S.W; LICSW
Social Worker (Clinical)
26246 CRANE RD
WHITE EARTH, MN 56591
Becker County (218) 983-3286

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 Kristin Petersen's NPI number?

The NPI number for Kristin Petersen is 1710422779. It was assigned to this individual provider in the NPPES registry on December 30, 2016.

Where is Kristin Petersen located?

Kristin Petersen practices at 26246 Crane Rd, White Earth, MN 56591. The listed phone number is (218) 983-4703.

What is Kristin Petersen's specialty?

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

Is Kristin Petersen enrolled in Medicare?

Yes. Kristin Petersen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kristin Petersen was last updated on December 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.