David R Petty Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW009570 Issued in GA

Practice address

714 Pownal LN
Hampton, GA 30228-6185

Phone

(678) 481-8883

NPI assigned

Oct 9, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1205701158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 POWNAL LN",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302286185",
            "telephone_number": "678-481-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 POWNAL LN",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302286185",
            "telephone_number": "678-481-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priya Patel, PHARM.D.
• Adrienne Peart, NP
• Veronica Angela Pentecost
• Tearra Perkins
• Stacy Petit-Jones, RN
• Valentina Pharms-McNeill
• Semone Phillip, MD
• Phoenix Emergency Medical Services LLC
• Physically Empowered Therapy & Wellness
• Kassandra Pierre Louis

• Clinical Social Worker in Hampton, GA
• Providers in Hampton, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.