Individual
VANESSA PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
204 N MAIN ST, ELIZABETHTOWN, KY 42701-1417
(270) 360-1222
Mailing address
100 CORTLAND CT, ELIZABETHTOWN, KY 42701-6481
(270) 317-6117
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
257243
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257243
MEDICARE
KY
Enumeration date
10/14/2022
Last updated
10/14/2022
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