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

Robert John Peterson, LICSW

Individual provider Clinical Social Worker · NPI 1922336684

Robert John Peterson, LICSW is a Clinical Social Worker in Loon Lake, Washington. Practices as a sole proprietor and works from 2 locations. Licensed in New Mexico and Washington.

Licensed in
NM, WA
In the registry since
2009
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

40647 Lake Rd
Loon Lake, WA 99148-9795
Phone: (509) 939-5515
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 Center St, Moriarty, NM 87035-2000 — (505) 832-5817

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 60174553 (WA)
Social Worker Taxonomy 104100000X · Licence X-06759 (NM)

Record details

NPI number1922336684
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedNovember 18, 2009
Last updated in NPPESNovember 9, 2023
Certification dateNovember 9, 2023
Mailing address40647 Lake Rd, Loon Lake, WA 99148-9795

Other providers in Loon Lake