Individual
MRS. JANELLE ELISE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
40071
ID
1041C0700X
Clinical Social Worker
Primary
L4742
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090450
—
OR
05
—
165772
—
OR
Enumeration date
10/08/2008
Last updated
03/05/2026
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