ROBERT JOHN PETERSON LICSW NPI 1922336684

NPI Information

  • NPI: 1922336684
  • Provider Name: ROBERT JOHN PETERSON, LICSW
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 40647 LAKE RD
    LOON LAKE, WA
    ZIP 99148
  • Phone: (509) 939-5515

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NPI Details

Robert John Peterson, LICSW is a clinical social worker in Loon Lake, WA. The provider is 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. Robert John Peterson, LICSW NPI is 1922336684. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

40647 LAKE RD
LOON LAKE, WA
ZIP 99148-795
Phone: (509) 939-5515

The enumeration date for this NPI number is 11/18/2009 and was last updated on 11/9/2023.

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
11041C0700XSocial WorkerClinical60174553WASHINGTONYes
2104100000XSocial WorkerX-06759NEW MEXICONo

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
1336712OTHERNEW MEXICOPED LICENSE
2X-06759OTHERNEW MEXICOSTATE LICENSE

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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