Individual
JAMES PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3141 CENTENNIAL BLVD, COLORADO SPRINGS, CO 80907-4094
(719) 227-4057
Mailing address
3141 CENTENNIAL BLVD, COLORADO SPRINGS, CO 80907-4094
(719) 227-4330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019302468
MO
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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