Individual provider Active NPI

Brittni Nicole Petrosy

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1083362057
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT128609 Issued in CA
Practice address
850 Colorado Blvd Ste 202
Los Angeles, CA 90041-1733
Phone
(323) 451-2055
NPI assigned
Mar 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APCC11163 CA
Marriage & Family Therapist 106H00000X AMFT128609 CA Primary

Addresses

Primary practice location

850 Colorado Blvd Ste 202
Los Angeles, CA 90041-1733

Mailing address

PO Box 1233
La Canada Flintridge, CA 91012-5233
Phone (626) 708-0442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APCC11163CAMDProfessional Counselor
AMFT128609CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1083362057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1233",
            "city": "LA CANADA FLINTRIDGE",
            "state": "CA",
            "postal_code": "910125233",
            "telephone_number": "626-708-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLORADO BLVD STE 202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900411733",
            "telephone_number": "323-451-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSY",
        "first_name": "BRITTNI",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "APCC11163",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT128609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.