| Heidi Peterson, Licsw | |
|
160 Benmont Ave Ste 20 Bennington VT 05201-1842 | |
| (802) 442-3520 | |
| Not Available |
| Full Name | Heidi Peterson, Licsw |
|---|---|
| Speciality | Social Worker |
| Location | 160 Benmont Ave Ste 20, Bennington, Vermont |
| Authorized Official Name and Position | Heidi Peterson (OWNER) |
| Authorized Official Contact | 8024423520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heidi Peterson, Licsw Po Box 846 Bennington VT 05201-0846 Ph: (802) 442-3520 | Heidi Peterson, Licsw 160 Benmont Ave Ste 20 Bennington VT 05201-1842 Ph: (802) 442-3520 |
| NPI Number | 1932551991 |
|---|---|
| Provider Enumeration Date | 07/01/2016 |
| Last Update Date | 07/01/2016 |
| Medicare PECOS PAC ID | 4183910342 |
|---|---|
| Medicare Enrollment ID | O20160914001736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932551991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Heidi Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770687220 PECOS PAC ID: 6002824018 Enrollment ID: I20060403000621 |
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