Individual
MR. JAMES RANDALL PETERS
Active
Individual
MR. JAMES RANDALL PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW014391
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018917920001
—
PA
01
—
023539
VMC BEHAVIORAL HEALTH CAR
—
01
—
104836
MAGELLAN
PA
01
—
472500
VALUE OPTIONS
—
01
—
910493
HIGHMARK BCBS
PA
Enumeration date
02/21/2007
Last updated
09/13/2013
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