JENSINE PETERSON (LCSW) – Clinical Social Worker, NPI 1427868546

JENSINE PETERSON (LCSW) is a healthcare provider. based in Portland, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. L11844 (OR). The NPI Number for JENSINE PETERSON (LCSW) is 1427868546

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JENSINE PETERSON (LCSW)
NPI
1427868546
Phone
(608) 469-8605
Address
4730 SE BELMONT ST APT 3
Enumeration Date
10 January 2025
Last Update Date
10 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5036666575
Graduation Year
2019 (7 years ago)
PAC ID
3476082264
Group Practice PAC ID
1557460524
Professional Enrollment ID
I20250123001331
Address ID
OR970304618GR4104XSTXX400
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

1,405 CLINICAL SOCIAL WORKER in OR

Provider Addresses for JENSINE PETERSON (LCSW)

  • 4730 SE BELMONT ST APT 3

    PORTLAND, OR 972151772

    Phone: (608) 469-8605

    Type: Mailing

  • 4101 NE DIVISION ST

    GRESHAM, OR 970304617

    Phone: (503) 666-6575

    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: 2025-01-23

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
I20250123001331IClinical Social WorkerORTBD

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 97215)

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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: 1557460524View full group profile
NameSpecialtyState
-OR
P S Y C H I A T R YOR

Reviews

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Frequently asked questions

What is the standard ID for JENSINE PETERSON (LCSW) in the U.S.?
In the U.S., JENSINE PETERSON (LCSW) is identified by NPI 1427868546.
Should I treat JENSINE PETERSON (LCSW) as an active provider?
Patients and plans typically see JENSINE PETERSON (LCSW) as active in the national extract.
How should patients interpret JENSINE PETERSON (LCSW)'s specialty?
The extract shows Clinical Social Worker for JENSINE PETERSON (LCSW). Clinical services aligned with this taxonomy classification.
Which community is linked to JENSINE PETERSON (LCSW)?
JENSINE PETERSON (LCSW) shows a connection to Portland, Oregon in registry-derived data.
Can I export JENSINE PETERSON (LCSW)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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