Emily Petkus

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701007185 Issued in VA

Practice address

58 Kenmore St
Harrisonburg, VA 22801

Phone

(540) 251-7728

NPI assigned

Apr 22, 2013

Last updated

Dec 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shenandoah Psychological Services, LLC

  • Clinical Psychologist
  • Harrisonburg, VA
  • NPI 1851717078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545436800000",
    "number": "1023452067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 KENMORE ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228014338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 KENMORE ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "22801",
            "telephone_number": "540-251-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 W Washington St",
            "address_2": "Suite 340",
            "address_purpose": "LOCATION",
            "city": "Oswego",
            "state": "IL",
            "postal_code": "605438214",
            "country_code": "US",
            "telephone_number": "630-383-2077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETKUS",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2018-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114281870",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Lauren Petefish, COTA
• Joshua L Petersheim, DPT
• Connie Lee Peterson, ATC, PHD
• Jumar D Peterson, M.ED
• Kevin S Petit, PT
• Alex Petsko
• Danielle Peyton, MS, LPC
• Cori Pflugradt, PA-C
• Alyssa Nicole Phelps, M.D.
• Philip J. Pandolfi, DMD, PLLC

• Mental Health Counselor in Harrisonburg, VA
• Providers in Harrisonburg, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.