Abigail Joy Petersen
NPI 1104539741ActiveIndividual· Social Worker, Clinical· New Brighton, MN
Social Worker, Clinical in New Brighton, Minnesota, licensed in MN, with an NPI issued in December 2022. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1104539741 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Dec 28, 2022 |
| Last updated in NPPES | Dec 28, 2022 |
| Certified by provider | Dec 28, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 77404 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MN) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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