Active NPI
Cheryl Anne Petosa, MED,CMHS
- Counselor
- Coupeville, WA
National Provider Identifier
1386828465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG60202326
- Practice address
- 105 N.W. 1St St.
Coupeville, WA 98239-0160 - Phone
- (360) 678-5555
- Fax
- (360) 678-3636
- NPI assigned
- Dec 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60202326 | WA | Primary |
Addresses
Primary practice location
105 N.W. 1St St.
Coupeville, WA 98239-0160
Mailing address
PO Box 160
Coupeville, WA 98239-0160
Phone (360) 678-5555
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60202326 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1386828465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 160",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "982390160",
"telephone_number": "360-678-5555",
"fax_number": "360-678-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N.W. 1ST ST.",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "982390160",
"telephone_number": "360-678-5555",
"fax_number": "360-678-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETOSA",
"first_name": "CHERYL",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MED,CMHS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-24",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60202326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coupeville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.