Veronica Faye Petkus, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12411 Issued in FL

Practice address

418 Treemonte Dr
Orange City, FL 32763-7978

Phone

(386) 212-3643

NPI assigned

May 14, 2014

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Veronica Petkus, LLC

  • Mental Health Counselor
  • Orange City, FL
  • NPI 1780146100
  NPD (past) Authorized official

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1134530934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 TREEMONTE DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637978",
            "telephone_number": "386-212-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 TREEMONTE DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637978",
            "telephone_number": "386-212-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETKUS",
        "first_name": "VERONICA",
        "middle_name": "FAYE",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.psychologytoday.com",
            "affiliation": "N",
            "address_1": "418 Treemonte Dr",
            "city": "Orange City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327637978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Orange City, FL
• Providers in Orange City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.