Brian Petry Licensed Professional Clinical Counselor Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

BRIAN PETRY LICENSED PROFESSIONAL CLINICAL COUNSELOR INC.

Practice address

10275 Hole Ave Unit 7083
Riverside, CA 92513-3404

Phone

(951) 344-1444

NPI assigned

Mar 6, 2025

Organization subpart

No

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

Authorized official

Name

Brian Petry, MA, MBA, LPCC, LMFTNPI 1043968134

Title

Ceo

Phone

(951) 344-1444

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Petry, MA, MBA, LPCC, LMFT

  • Marriage & Family Therapist
  • Riverside, CA
  • NPI 1043968134

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1194523035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7083",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10275 HOLE AVE UNIT 7083",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925133404",
            "telephone_number": "951-344-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN PETRY LICENSED PROFESSIONAL CLINICAL COUNSELOR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-344-1444",
        "authorized_official_credential": "MA, MBA, LPCC, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.