Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Abigail Joy Petersen

Individual provider Clinical Social Worker · NPI 1104539741

Abigail Joy Petersen is a Clinical Social Worker in New Brighton, Minnesota. Qualified in 2022, 4 years ago. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2022
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Practice location Address checks out

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone: (763) 477-1367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 77404 (MN)

Record details

NPI number1104539741
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 28, 2022
Last updated in NPPESDecember 28, 2022
Certification dateDecember 28, 2022
Mailing address1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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