Provider Demographics
NPI:1487059952
Name:PETERSON, BRITTANY ANNE (MSW, QMHP)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:ANNE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MSW, QMHP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANNE
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2025 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5131
Mailing Address - Country:US
Mailing Address - Phone:847-360-1020
Mailing Address - Fax:847-360-1065
Practice Address - Street 1:2025 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-5131
Practice Address - Country:US
Practice Address - Phone:847-360-1020
Practice Address - Fax:847-360-1065
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker