Petersen, Ellen
Petersen, Ellen is an sole proprietor health care provider with primary practice located at 13137 University Ave Ste 140 , Clive IA 50325-8299. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Petersen, Ellen can be contacted via phone (515) 758-9606.Contact Information
Primary practice address
13137 University Ave Ste 140
Clive IA 50325-8299
Phone: (515) 758-9606
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 087080 | Iowa |
Profile Details
| NPI number | 1710403001 |
|---|---|
| LBN Legal business name | Petersen, Ellen |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2017 |
| Last updated | May 21st, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710403001 | NPPES |
| Iowa | MEDICAID | 0076372 |
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