Individual
MS. NINA ESCOBAR PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1535 NE RICE RD, LEES SUMMIT, MO 64086-5849
(816) 966-0900
(816) 347-3209
Mailing address
1555 NE RICE RD, LEES SUMMIT, MO 64086-5849
(816) 347-3069
(816) 347-3200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2014008259
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50560039
BLUE CROSS BLUE SHIELD - BLUE KC
MO
Enumeration date
03/30/2010
Last updated
05/11/2023
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