Individual provider Active NPI

Deborah Pettway

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
National Provider Identifier
1255889416
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3855 Issued in TX
Practice address
1200 Binz St Ste 850
Houston, TX 77004-6933
Phone
(281) 387-7089
Fax
(713) 486-5661
NPI assigned
Sep 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3855 TX Primary

Addresses

Primary practice location

1200 Binz St Ste 850
Houston, TX 77004-6933

Mailing address

1200 Binz St Ste 850
Houston, TX 77004-6933
Phone (281) 387-7089

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
3855TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1255889416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 850",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046933",
            "telephone_number": "281-387-7089",
            "fax_number": "713-486-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 850",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046933",
            "telephone_number": "281-387-7089",
            "fax_number": "713-486-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "DEBORAH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "3855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.