Petrina Woody, LCSW, LCDC, EMDR TRN

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

66808 Issued in TX

Practice address

11824 Alexandria Dr
McKinney, TX 75071-6374

Phone

(214) 770-2081

NPI assigned

Apr 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Collin County Mental Health Mental Retardation Center

  dba LifePath Systems

  • Mental Health Counselor
  • McKinney, TX
  • NPI 1871576835

  Clinical

  Medicare reassignment NPD
• Nu-Lavie Wellness PLLC

  • Clinical Social Worker
  • Lewisville, TX
  • NPI 1588363337
  NPD Authorized official

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1396325171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11824 ALEXANDRIA DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716374",
            "telephone_number": "214-770-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11824 ALEXANDRIA DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716374",
            "telephone_number": "214-770-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODY",
        "first_name": "PETRINA",
        "credential": "LCSW, LCDC, EMDR TRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wonderfully Made Wellness Sanctuary
• Holly Leeann Wood
• Courtney Lynn Woodard
• Woodlennium Transportation Services
• John Woodruff, LPC-S
• Robin Wornhor, RN
• Crystal Diane Worth
• Wound Healing Center of Texas
• Brandie Wright
• Joshua Cole Wright, LMSW

• Clinical Social Worker in McKinney, TX
• Providers in McKinney, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.