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

Elishama Petersen

Individual provider Clinical Social Worker · NPI 1003682287

Elishama Petersen is a Clinical Social Worker in Wynantskill, New York. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

614 Cooper Hill Rd
Wynantskill, NY 12198-2906
Phone: (518) 283-6500
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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

Record details

NPI number1003682287
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 29, 2023
Last updated in NPPESNovember 29, 2023
Certification dateNovember 29, 2023
Mailing addressPo Box 219, Wynantskill, NY 12198-0219

Other providers in Wynantskill