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

Sarah Jane Petersen, LCSW

Individual provider Mental Health Counselor · NPI 1073228607

Sarah Jane Petersen, LCSW is a Clinical Social Worker in Beloit, Wisconsin. Qualified in 2019, 7 years ago. Practices with Stateline Mental Health Services, a 20-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2023
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

540 E Grand Ave
Beloit, WI 53511-6314
Phone: (608) 368-8087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1073228607
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJanuary 18, 2023
Last updated in NPPESMay 1, 2024
Certification dateMay 1, 2024
Mailing address540 E Grand Ave, Beloit, WI 53511-6314

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Stateline Mental Health Services — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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