Individual provider Active NPI

Walkens Petit-Frere, LMSW

  • Psychoanalyst
  • Brooklyn, NY
National Provider Identifier
1194329953
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
112377 Issued in NY
Practice address
348 13TH St Ste 203
Brooklyn, NY 11215-6179
Phone
(917) 499-9876
NPI assigned
Nov 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 112377 NY Primary

Addresses

Primary practice location

348 13TH St Ste 203
Brooklyn, NY 11215-6179

Mailing address

2427 Adam Clayton Powell Jr Blvd Apt 2a
New York, NY 10030-1770
Phone (917) 499-9876

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
112377NYMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1194329953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 ADAM CLAYTON POWELL JR BLVD APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100301770",
            "telephone_number": "917-499-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 13TH ST STE 203",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156179",
            "telephone_number": "917-499-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT-FRERE",
        "first_name": "WALKENS",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "112377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.