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General NPI Number Information
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NPI Number | 1093265761
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Entity Type | Organization
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Legal Business Name | BARBARA PETERSEN-FOX, LISW, LLC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 1200 VALLEY WEST DR STE 702
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1907
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Country | US
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Telephone | 515-225-1940
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 VALLEY WEST DR STE 702
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1907
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Country | US
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Telephone | 515-225-1940
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MS. BARBARA PETERSEN-FOX
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Credential | LISW
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Telephone | 515-250-7380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 01826
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License Number State | IA
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