Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710330865 Individual Practitioner Female Practitioner

Kishmar Petersen

Social Worker • Daytona Beach, FL

Professional Overview & Biography Verified Profile Summary

Kishmar Petersen is a registered healthcare professional specializing in Social Worker in Daytona Beach, FL. Practice services are available at 589 SOUTH CT under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

589 South Ct

Daytona Beach, FL 321146009

Telephone 3868681992
Associated Practice Facility / Clinic
🏢 A Helping Hand Inc Facility NPI 1578853370

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Daytona Beach, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.8 Yrs
Regional Practice Density
65 Specialists

Practicing in Daytona Beach, FL (5606 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
NPI 1003214339
Stephen Odu

Counselor - Mental Health

NPI 1023446721
Tracy Long , RN, BSN

Registered Nurse - Psychiatric/Mental Health, Child & Adolescent

NPI 1023596657

Registered Nurse, Bachelor of Science in Nursing

Julie Schoonover , BS

Case Manager/Care Coordinator

NPI 1043351828

Bachelor of Science

Kohei Mochizuki , LMHC

Counselor - Mental Health

NPI 1093038499

Licensed Mental Health Counselor

Karan Crawford , LPN

Licensed Practical Nurse

NPI 1104215979

Licensed Practical Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 13, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location July 13, 2016

Registered at 589 SOUTH CT, DAYTONA BEACH, FL 321146009 (Tel: 3868681992)

📍
Updated Business Mailing Address July 13, 2016

Registered at 589 SOUTH CT, DAYTONA BEACH, FL 321146009 (Tel: 3868681992)

👤
Provider Name / Credentials Updated July 13, 2016

Recorded as KISHMAR PETERSEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2016

Social Worker

🟢
Initial NPI Registration & Enumeration July 13, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710330865
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2016
Last Update: July 13, 2016
Sole Proprietor: Yes

Mailing Address

589 South Ct

Daytona Beach, FL 321146009

Phone: 3868681992

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.