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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1902421118

Kirsten Marie Petron, LCSW, CDCII is a Clinical Social Worker in Wasilla, Alaska. Qualified in 2021, 5 years ago. Practices with Southcentral Foundation, a 170-clinician group and accepts Medicare assignment. Licensed in Alaska.

Years since qualifying
5
Licensed in
AK
In the registry since
2020
Specialties on file
2
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

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone: (907) 631-7670
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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 213013 (AK)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 3155 (AK)

Record details

NPI number1902421118
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , CDCII
Sole proprietorNo
NPI enumeratedJune 12, 2020
Last updated in NPPESJuly 29, 2024
Certification dateJuly 29, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Southcentral Foundation — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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