Jennifer Petty

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60594245 Issued in WA

Practice address

1817 Queen Anne Ave N Ste 309
Seattle, WA 98109-2876

Phone

(206) 319-5886

NPI assigned

Apr 16, 2016

Last updated

Feb 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 3, 2024 through Jan 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jennifer Petty LLC

  dba Seattle Counseling Center

  • Mental Health Counselor
  • Seattle, WA
  • NPI 1316442759
  NPD Authorized official

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1033563028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 QUEEN ANNE AVE N STE 313",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 QUEEN ANNE AVE N STE 309",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092876",
            "telephone_number": "206-319-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60594245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Y. Pettis, DDS, MMED.SC.
• Kaleigh Pettis, LMFT
• Samuel R. Pettis, M.D.
• Casandra Petty
• Charles Neuman Petty, MD
• Theophile Kouam Peumeu, RN
• Kye Peven, ND, DSOM, EAMP
• Mary Catharine Pew, MD
• Heather Lynn Peycke, LMP
• Mackenzie Sue Peyton, MSW

• Mental Health Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.