Individual provider Active NPI

Harold Jay Petry II, LMHC

  • Mental Health Counselor
  • St Petersburg, FL
National Provider Identifier
1285894980
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9052 Issued in FL
Practice address
3600 Central Ave
St Petersburg, FL 33711-1345
Phone
(727) 826-0700
Fax
(727) 954-6994
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1816 WV
Mental Health Counselor 101YM0800X MH9052 FL Primary

Addresses

Primary practice location

3600 Central Ave
St Petersburg, FL 33711-1345

Mailing address

3600 Central Ave
St Petersburg, FL 33711-1345
Phone (727) 826-0700

Other practice location 1

1525 16th St S
St Petersburg, FL 33705-2447
Phone (727) 826-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20250728003214 FL Practitioner - Mental Health Counselor 0143737841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Love the Golden Rule IncGroup PAC ID 3971820481, 3 clinicians

Practice addresses (Care Compare)

3600 Central Ave
St Petersburg, FL 33711-1345
Phone (727) 826-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH9052FLMDMental Health Counselor
1816WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Love the Golden Rule Inc CurrentSince Jun 24, 2025 Accepting new patients

Locations

1525 16th St S
St Petersburg, FL 33705
Phone (727) 826-0700

3000 1st Ave N
St Petersburg, FL 33713
Phone (727) 328-7400

3600 Central Ave
St Petersburg, FL 33711
Phone (727) 322-4227

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJJCDD/Endpoint/BJJCDD
  • Direct secure messaging: harold.petry@370800551460868.direct.elationemr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1285894980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111345",
            "telephone_number": "727-826-0700",
            "fax_number": "727-954-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111345",
            "telephone_number": "727-826-0700",
            "fax_number": "727-954-6994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 16th St S",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337052447",
            "country_code": "US",
            "telephone_number": "727-826-0700",
            "fax_number": "727-954-6994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRY",
        "first_name": "HAROLD",
        "middle_name": "JAY",
        "name_suffix": "II",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1816",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.