Mr Kyle Peterson, LCSW is a
Social Worker - Clinical based in Madison, Wisconsin. Mr Kyle Peterson is licensed to practice in Wisconsin (license number 9983-123) and his current practice location is
1202 Northport Dr, Madison, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(608) 921-8289.
NPI number for Mr Kyle Peterson is 1700466117 and his current mailing address is 1202 Northport Dr, Madison, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1700466117.
Healthcare Provider's Profile
| Full Name | Mr Kyle Peterson |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1202 Northport Dr, Madison, Wisconsin |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1700466117
- Provider Enumeration Date: 04/09/2021
- Last Update Date: 09/26/2023
Medical Identifiers
Medical identifiers for Mr Kyle Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1700466117 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19344-130 (Wisconsin) | Secondary |
| 104100000X | Social Worker | 131900-121 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 9983-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kyle Peterson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Kyle Peterson, LCSW
1202 Northport Dr,
Madison, WI 53704-2020
Ph: () - | Mr Kyle Peterson, LCSW
1202 Northport Dr,
Madison, WI 53704-2020
Ph: (608) 921-8289 |
Reviews and Comments