John Peterson, LISW, CDCA is a
Social Worker - Clinical based in Canton, Ohio. John Peterson is licensed to practice in Ohio (license number I1801316) and his current practice location is
733 Market Ave S, Canton, Ohio. He can be reached at his office (for appointments etc.) via phone at
(330) 489-4600.
NPI number for John Peterson is 1023464682 and his current mailing address is 1341 Market Ave N, Canton, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023464682.
Healthcare Provider's Profile
| Full Name | John Peterson |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 733 Market Ave S, Canton, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023464682
- Provider Enumeration Date: 05/12/2016
- Last Update Date: 11/30/2018
Medical Identifiers
Medical identifiers for John Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023464682 | NPI | - | NPPES |
| 2901131 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0012311 (Ohio) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 011229 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I1801316 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. John Peterson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
John Peterson, LISW, CDCA
1341 Market Ave N,
Canton, OH 44714-2605
Ph: (330) 453-8252 | John Peterson, LISW, CDCA
733 Market Ave S,
Canton, OH 44702-2165
Ph: (330) 489-4600 |
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