Individual
MR. KYLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
440 SCIENCE DR STE 300, MADISON, WI 53711-1064
(262) 999-3495
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19344-130
WI
104100000X
Social Worker
131900-121
WI
1041C0700X
Clinical Social Worker
Primary
9983-123
WI
Other
Enumeration date
04/09/2021
Last updated
02/18/2026
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