| Sarah Peterson Lcsw Llc | |
|
147 Sw Shevlin Hixon Dr Ste 104 Bend OR 97702-3185 | |
| (541) 480-1237 | |
| (541) 623-2585 |
| Full Name | Sarah Peterson Lcsw Llc |
|---|---|
| Speciality | Counselor |
| Location | 147 Sw Shevlin Hixon Dr Ste 104, Bend, Oregon |
| Authorized Official Name and Position | Sarah Elizabeth Peterson (OWNER) |
| Authorized Official Contact | 5417718769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sarah Peterson Lcsw Llc 63480 Phoenix Way Bend OR 97701-8009 Ph: (541) 480-1237 | Sarah Peterson Lcsw Llc 147 Sw Shevlin Hixon Dr Ste 104 Bend OR 97702-3185 Ph: (541) 480-1237 |
| NPI Number | 1316503105 |
|---|---|
| Provider Enumeration Date | 05/16/2019 |
| Last Update Date | 08/11/2023 |
| Certification Date | 08/11/2023 |
| Medicare PECOS PAC ID | 1052645975 |
|---|---|
| Medicare Enrollment ID | O20190626004088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316503105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amy Fisher King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932498524 PECOS PAC ID: 0648415901 Enrollment ID: I20130315000034 |
| Provider Name | Sarah Elizabeth Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366008856 PECOS PAC ID: 2961736889 Enrollment ID: I20190626004090 |
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