Samantha Jo Petersen, APSW
NPI 1043101991ActiveIndividual· Social Worker· Menasha, WI
Social Worker (APSW) in Menasha, Wisconsin, licensed in WI, with an NPI issued in July 2025. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1043101991 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APSW |
| Sole proprietor | No |
| NPI issued | Jul 10, 2025 |
| Last updated in NPPES | Jul 10, 2025 |
| Certified by provider | Jul 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 135619-121 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WI) |
|---|
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