Bernice Petty

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

163462 Issued in OH

Practice address

1496 S Green Rd
South Euclid, OH 44121-4088

Phone

(162) 389-7413

Fax

(216) 916-0995

NPI assigned

Sep 29, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Bernice Ford Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dare to Be Different, LLC

  • Private Vehicle
  • Cleveland Heights, OH
  • NPI 1043924145
  NPD Authorized official
• Dare to Be Different, LLC

  • Adult Care Home Facility
  • Cleveland Heights, OH
  • NPI 1710536354
  NPD Authorized official
• I'M in Transition Ministries

  • Community/Behavioral Health Agency
  • South Euclid, OH
  • NPI 1669146890

  Single Specialty

  NPD

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1396254652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 S GREEN RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214088",
            "telephone_number": "162-389-7413",
            "fax_number": "162-916-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 S GREEN RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214088",
            "telephone_number": "162-389-7413",
            "fax_number": "216-916-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "BERNICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "163462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNICE",
            "last_name": "FORD",
            "prefix": "MRS.",
            "credential": "CDCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chamika Peacock
• Alexandra Pearl, M.A. CCC-SLP
• Antoine Perry
• Miesha Vonne Peterson, LPN
• Nefertiti H Peterson, RN
• Lori Elizabeth Peysha, CNP
• Joseph Peysin, BCBA
• Place to Call Home LLC
• Planet Meals
• Alexis Marie Plucinsky, DMD

• Professional Counselor in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.