Jessica Marie Petri, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004632 Issued in GA

Practice address

1030 Grant St SE Ste 4
Atlanta, GA 30315-2015

Phone

(470) 485-2047

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

No

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

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Anxiety and Trauma Clinic of Atlanta

  • Adult Mental Health Clinic/Center
  • Atlanta, GA
  • NPI 1437877495
  NPD

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1255051017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 GRANT ST SE STE 4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303152015",
            "telephone_number": "470-485-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 GRANT ST SE STE 4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303152015",
            "telephone_number": "470-485-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRI",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drpetri@anxietytraumaclinic.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1030 Grant St SE Ste 4",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303152015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Peterson, PA-C
• Susan C. Peterson, PA-AA
• Christine Petit-Frere
• Valene Ann Petit, LPN
• Leslie M Petosa, PAAA
• Ruta Gabriele Petrikis
• Pamela Petrillo
• Allison Laura Petro, NP
• John A Petros, M.D.
• Sarah G Petruccelli-Bedgood

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.