| Doctor Name: | CAROLYN PETERSON |
| NPI Number: | 1033406509 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 0904001654 |
| Business Practice Address: | 610 Campus Dr Abingdon, VA - 242102589 |
| Business Phone Number: | 2765251587 |
| Business Fax Number: | 2765251609 |
| Mailing Address: | 610 Campus Dr, ABINGDON |
| State: | VA |
| Postal Code: | 242102589 |
| Phone Number: | 2765251587 |
| Fax Number: | 2765251609 |
| NPI Enumeration Date: | 07/06/2011 |
| NPI Last Update Date: | 07/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904001654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |