Active NPI
Janet Eileen Petrou
- Mental Health Counselor
- Baldwinsville, NY
National Provider Identifier
1063194868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R079029-01
- Practice address
- 3182 Samantha Dr
Baldwinsville, NY 13027-8980 - Phone
- (315) 373-1397
- NPI assigned
- Aug 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R079029-01 | NY | Primary |
Addresses
Primary practice location
3182 Samantha Dr
Baldwinsville, NY 13027-8980
Mailing address
4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 492-5647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240615000094 | NY | Practitioner - Clinical Social Worker | 1850834128 | Practice locations: Baldwinsville, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3182 Samantha Dr
Baldwinsville, NY 13027-8980
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R079029-01 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1063194868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 BROAD RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132152265",
"telephone_number": "315-492-5647",
"fax_number": "315-492-5809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3182 SAMANTHA DR",
"city": "BALDWINSVILLE",
"state": "NY",
"postal_code": "130278980",
"telephone_number": "315-373-1397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROU",
"first_name": "JANET",
"middle_name": "EILEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-02",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "R079029-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baldwinsville, NY
- Lorraine Wilson Perkins, M.S.,CCC-SLP
- Michael A Persin, RN
- Christina Marie Peters, MS-CCC/SLP
- Anthony L Petote, RD
- Mark Joseph Petrie, MA LMFT
- Phoenix Equestrian Warriors-Rescue-Rehab & Restore Inc.
- Phoenix Rising Counseling & Recovery Services
- Phoenix Rising Counseling & Recovery Services
- Linda Beth Pientka, LPN
- Pinnacle DMX Imaging, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.