Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710403001 Individual Practitioner Female Practitioner

Ellen Petersen , LISW

Social Worker • Clive, IA

Professional Overview & Biography Verified Profile Summary

Ellen Petersen, LISW is a registered healthcare professional specializing in Social Worker in Clive, IA. Practice services are available at 13137 UNIVERSITY AVE STE 140 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

13137 University Ave Ste 140

Clive, IA 503258299

Telephone 5157589606
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Clive, IA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.8 Yrs
Regional Practice Density
7 Specialists

Practicing in Clive, IA (1187 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

CMS Verified: 2025-05-21
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

State License IA 087080

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0076372 (IA)

Practice Associates & Co-Workers

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

2 Associated Practitioners
Chad Peters

Counselor - Mental Health

NPI 1528859923
Jennifer Olson

Counselor - Mental Health

NPI 1629882980

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location March 19, 2025

Registered at 13137 UNIVERSITY AVE STE 140, CLIVE, IA 503258299 (Tel: 5157589606)

📍
Updated Business Mailing Address March 19, 2025

Registered at 13137 UNIVERSITY AVE STE 140, CLIVE, IA 503258299 (Tel: 5157589606)

📍
Updated Business Mailing Address July 20, 2020

Registered at 905 FRANKLIN ST, WATERLOO, IA 507034407 (Tel: 3198743000)

👤
Provider Name / Credentials Updated July 20, 2020

Recorded as ELLEN PETERSEN, LISW

NPI Profile Active August 17, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 17, 2017

Registered at 1916 WATERFRONT DR, IOWA CITY, IA 522404416 (Tel: 3193374523)

📍
Updated Business Mailing Address August 17, 2017

Registered at 1916 WATERFRONT DR, IOWA CITY, IA 522404416

👤
Provider Name / Credentials Updated August 17, 2017

Recorded as ELLEN PETERSEN, LMSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 17, 2017

Social Worker (License #087080 in IA)

🟢
Initial NPI Registration & Enumeration August 17, 2017

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: 1710403001
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 17, 2017
Last Update: May 21, 2025
Sole Proprietor: Yes

Mailing Address

13137 University Ave Ste 140

Clive, IA 503258299

Phone: 5157589606

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.