MAIJA PETERFESO (MSW LICSW) – Clinical Social Worker, NPI 1104626167

MAIJA PETERFESO (MSW LICSW) is a healthcare provider. based in Edina, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW LICSW. They hold a License No. 15050 (MN). The NPI Number for MAIJA PETERFESO (MSW LICSW) is 1104626167

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MAIJA PETERFESO (MSW LICSW)
NPI
1104626167
Phone
(763) 703-4215
Address
7101 YORK AVE S STE 317
Enumeration Date
18 March 2025
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7637034215
Graduation Year
2021 (5 years ago)
PAC ID
3173049582
Group Practice PAC ID
2769828706
Professional Enrollment ID
I20250429002169
Address ID
MN554354469ED7101XSXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

Provider Addresses for MAIJA PETERFESO (MSW LICSW)

  • 7101 YORK AVE S STE 317

    EDINA, MN 554354469

    Phone: (763) 703-4215

    Fax: (877) 775-3306

    Type: Mailing

  • 1197 GRAND AVE

    SAINT PAUL, MN 551052634

    Phone: (763) 703-4215

    Fax: (877) 775-3306

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250429002169IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55435)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769828706View full group profile
NameSpecialtyState
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorWI
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What is MAIJA PETERFESO (MSW LICSW)'s NPI number?
MAIJA PETERFESO (MSW LICSW)'s NPI is 1104626167 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MAIJA PETERFESO (MSW LICSW)?
You should see MAIJA PETERFESO (MSW LICSW) as active in CMS-hosted NPPES data.
What area of care is associated with MAIJA PETERFESO (MSW LICSW)?
MAIJA PETERFESO (MSW LICSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MAIJA PETERFESO (MSW LICSW)?
Travel planning: use Edina, Minnesota as the reference point for MAIJA PETERFESO (MSW LICSW), then confirm.
When was this NPI issued?
Enumeration for MAIJA PETERFESO (MSW LICSW) is noted as March 18, 2025 where the registry provides it.

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