Peterson, Marjorie
Peterson, Marjorie is an sole proprietor health care provider with primary practice located at 6 Tods Driftway , Old Greenwich CT 06870-2412. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Peterson, Marjorie can be contacted via phone (203) 257-1411.Contact Information
Primary practice address
6 Tods Driftway
Old Greenwich CT 06870-2412
Phone: (203) 257-1411
Fax: (203) 257-1411
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 03248672006051 | Connecticut |
Profile Details
| NPI number | 1861568503 |
|---|---|
| LBN Legal business name | Peterson, Marjorie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 27th, 2006 |
| Last updated | Jun 6th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861568503 | NPPES |
| Connecticut | MEDICAID | 004172912 |
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