Active NPI
Wayne Earl Petties, LMSW
- Professional Counselor
- Dallas, TX
National Provider Identifier
1306001607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 214 W Colorado Blvd
Dallas, TX 75208-2326 - Phone
- (214) 943-9431
- NPI assigned
- Jul 25, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
214 W Colorado Blvd
Dallas, TX 75208-2326
Mailing address
214 W Colorado Blvd
Dallas, TX 75208-2326
Phone (214) 943-9431
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269907200000",
"number": "1306001607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 W COLORADO BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752082326",
"telephone_number": "214-943-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "214 W COLORADO BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752082326",
"telephone_number": "214-943-9431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIES",
"first_name": "WAYNE",
"middle_name": "EARL",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-25",
"last_updated": "2010-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.