Peterson, Jolene
Peterson, Jolene is an individual health care provider with primary practice located at 3200 Canyon Lake Dr , Rapid City SD 57702-8114. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Peterson, Jolene can be contacted via phone (605) 355-2215.Contact Information
Primary practice address
3200 Canyon Lake Dr
Rapid City SD 57702-8114
Phone: (605) 355-2215
Fax: (605) 355-2504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1265 | South Dakota |
Profile Details
| NPI number | 1033173349 |
|---|---|
| LBN Legal business name | Peterson, Jolene |
| Credentials | MSW LCSW PIP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2006 |
| Last updated | Apr 11th, 2022 - about 4 years ago |
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 | 1033173349 | NPPES |
| South Dakota | MEDICAID | 554090 |
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