| Teresa Peterson, LCSW | |
|
2010 Boren Blvd, Seminole, OK 74868-2050 | |
| (405) 382-4507 | |
| (405) 382-5269 |
| Full Name | Teresa Peterson |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 2010 Boren Blvd, Seminole, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780237602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6730 (Oklahoma) | Primary |
| Entity Name | Millennium Medical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245286285 PECOS PAC ID: 6204730856 Enrollment ID: O20040105000859 |
| Entity Name | Lighthouse Behavioral Wellness Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518997097 PECOS PAC ID: 6406748961 Enrollment ID: O20040329000653 |
| Mailing Address | Practice Location Address |
|---|---|
| Teresa Peterson, LCSW Po Box 1845, Seminole, OK 74818-1845 Ph: (405) 382-4507 | Teresa Peterson, LCSW 2010 Boren Blvd, Seminole, OK 74868-2050 Ph: (405) 382-4507 |
Linda Johns, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 223 N 2nd St, Seminole, OK 74868 Phone: 405-303-5000 Fax: 405-303-5002 | |
Sandra Lee Edwards, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2121 Phelps Dr, Seminole, OK 74868 Phone: 469-414-2151 |