Active NPI
Heather Petty, CSW
- Mental Health Counselor
- Georgetown, KY
National Provider Identifier
1295596260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 254933
- Practice address
- 200 Seminole TRL
Georgetown, KY 40324-1115 - Phone
- (859) 213-9646
- NPI assigned
- Jan 17, 2024
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 254933 | KY | Primary |
Addresses
Primary practice location
200 Seminole TRL
Georgetown, KY 40324-1115
Mailing address
PO Box 7159
Louisville, KY 40257-0159
Phone (855) 591-0092
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 |
|---|---|---|---|
| 254933 | KY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1295596260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7159",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402570159",
"telephone_number": "855-591-0092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SEMINOLE TRL",
"city": "GEORGETOWN",
"state": "KY",
"postal_code": "403241115",
"telephone_number": "859-213-9646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "HEATHER",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-17",
"last_updated": "2024-01-17",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "KY",
"license": "254933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.