Ellen Petersen, LISW
NPI 1710403001ActiveIndividual· Social Worker· Clive, IA
Social Worker (LISW) in Clive, Iowa, licensed in IA, with an NPI issued in August 2017. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1710403001 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LISW |
| Sole proprietor | Yes |
| NPI issued | Aug 17, 2017 |
| Last updated in NPPES | May 21, 2025 |
| Certified by provider | May 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | 087080 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IA) |
|---|
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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