Jennifer M Petrosky, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2406186 Issued in OH

Practice address

600 Freedom Dr
Napoleon, OH 43545-9021

Phone

(440) 234-2006

NPI assigned

Jan 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1154182178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FREEDOM DR",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459021",
            "telephone_number": "440-234-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2406186",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Goodwin Perrie, M.A. SLP-CCC
• Abbie Dawn Phillips, COTA/L
• Hannah Phillips
• Bethany Pieper
• Kylie Plotts
• Katherine Lynn Polzin, QMHS

• Professional Counselor in Napoleon, OH
• Providers in Napoleon, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.