Peterson, Kassandra Kay

Peterson, Kassandra Kay is an individual health care provider with primary practice located at 1833 3Rd Ave , Anoka MN 55303-5353. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Peterson, Kassandra Kay can be contacted via phone (651) 748-5019.

Contact Information

Primary practice address
1833 3Rd Ave Anoka MN 55303-5353
Phone: (651) 748-5019
Fax: (651) 773-7591
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1386961001
LBN Legal business name Peterson, Kassandra Kay
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2010
Last updated Dec 11th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386961001 NPPES
Minnesota MEDICAID 1386961001

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