ELLEN PETERSEN LISW NPI 1710403001

NPI Information

  • NPI: 1710403001
  • Provider Name: ELLEN PETERSEN, LISW
  • Classification: Social Worker - 104100000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 13137 UNIVERSITY AVE STE 140
    CLIVE, IA
    ZIP 50325
  • Phone: (515) 758-9606

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NPI Details

Ellen Petersen, LISW is a social worker in Clive, IA with 9 years of experience. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. Ellen Petersen, LISW NPI is 1710403001. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13137 UNIVERSITY AVE STE 140
CLIVE, IA
ZIP 50325-299
Phone: (515) 758-9606

The NPI 1710403001 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/17/2017 and was last updated on 5/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1104100000XSocial Worker087080IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10076372MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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