Active NPI
Linda Marie Sandel Pettit, ED.D
- Psychologist
- Morgantown, WV
National Provider Identifier
1255477899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 572
- Practice address
- 1445 Stewartstown Rd Ste 150
Morgantown, WV 26505-2949 - Phone
- (304) 777-4848
- Fax
- (304) 777-4849
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 572 | WV | Primary |
Addresses
Primary practice location
1445 Stewartstown Rd Ste 150
Morgantown, WV 26505-2949
Mailing address
PO Box 100
Bruceton Mills, WV 26525-0100
Phone (304) 692-4868
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
| License | State | Type | Specialty |
|---|---|---|---|
| 572 | WV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wisdomsources PLLC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Morgantown, WV
- NPI 1609053966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1255477899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "BRUCETON MILLS",
"state": "WV",
"postal_code": "265250100",
"telephone_number": "304-692-4868",
"fax_number": "304-777-4849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 STEWARTSTOWN RD STE 150",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052949",
"telephone_number": "304-777-4848",
"fax_number": "304-777-4849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "LINDA",
"middle_name": "MARIE SANDEL",
"name_prefix": "Dr.",
"credential": "ED.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WV",
"license": "572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.