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

Jessica Peterson, LCSW

Individual provider Clinical Social Worker · NPI 1669901260

Jessica Peterson, LCSW is a Clinical Social Worker in Coeur D Alene, Idaho. Qualified in 2017, 9 years ago. Practices with Ambitions of Idaho Inc, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
9
Licensed in
ID
In the registry since
2017
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1044 NW Blvd Ste C
Coeur D Alene, ID 83814-2114
Phone: (208) 930-1740
Fax: (208) 930-1695
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1038 Northwest Blvd, Coeur D Alene, ID 83814-2249 — (208) 930-1740

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-39938 (ID)

Record details

NPI number1669901260
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 7, 2017
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Ambitions Of Idaho Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Coeur D Alene