Individual
SHATAWNEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PMSW, PMHP
Contact information
Practice address
207 GALVIN RD N, BELLEVUE, NE 68005-4898
(402) 929-4372
(402) 702-0538
Mailing address
207 GALVIN RD N, BELLEVUE, NE 68005-4898
(402) 940-7387
(402) 702-0538
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8119
NE
1041C0700X
Clinical Social Worker
Primary
14171
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10029553600
—
NE
05
—
10281929001
—
NE
Enumeration date
11/22/2021
Last updated
03/16/2026
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