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Individual

MICKAELLE PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LMHP

Contact information

Practice address
4101 WOOLWORTH AVENUE, 117C- DORCAS, OMAHA, NE 68105
(402) 977-4467
Mailing address
2805 HUNTER DR, BELLEVUE, NE 68123-4621
(636) 866-1355

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2578
NE
1041C0700X
Clinical Social Worker
6396
NE

Other

Enumeration date
06/03/2024
Last updated
12/10/2025
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