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

Individual provider Clinical Social Worker · NPI 1952996894

Peter Lyle Noteboom, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 2018, 8 years ago. Practices with Hennepin County, a 132-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
8
Licensed in
MN
In the registry since
2021
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1313 Penn Ave N
Minneapolis, MN 55411-3047
Phone: (612) 543-2500
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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 27334 (MN)

Record details

NPI number1952996894
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedMarch 3, 2021
Last updated in NPPESNovember 17, 2021
Certification dateJuly 12, 2021

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Hennepin County — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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