Individual provider Active NPI

Andrea Petraitis

  • Clinical Social Worker
  • Dover, NH
National Provider Identifier
1104710359
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5531 Issued in NH
Practice address
2 Washington St Ste 210
Dover, NH 03820-3889
Phone
(603) 605-1804
NPI assigned
Jun 4, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5531 NH Primary

Addresses

Primary practice location

2 Washington St Ste 210
Dover, NH 03820-3889

Mailing address

2 Washington St Ste 210
Dover, NH 03820-3889

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
5531NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care Counseling Services LLC Clinical CurrentSince Jun 8, 2025 Accepting new patients
Sage and Stone Integrative Therapy LLC. Clinical Current Accepting new patients

Locations

2 Washington St
Ste 210
Dover, NH 03820
Phone (603) 605-1804

70 Stark St
Manchester, NH 03101
Phone (603) 270-9181

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1104710359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WASHINGTON ST STE 210",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WASHINGTON ST STE 210",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203889",
            "telephone_number": "603-605-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAITIS",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-04",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "5531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.