Michelle Petrongolo, PSY.D., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

123 Egg Harbor Rd Ste 302
Sewell, NJ 08080-9406

Phone

(856) 278-6095

Fax

(866) 567-5687

NPI assigned

Sep 17, 2012

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 NJ

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 Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Positive State Psychological & Behavioral Services, LLC

  • Community/Behavioral Health Agency
  • Pitman, NJ
  • NPI 1194447599
  Medicare reassignment NPD Authorized official
• Integrative Psychology Associates of South Jersey , LLC

  • Clinical Psychologist
  • Sewell, NJ
  • NPI 1003331315
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1447500574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EGG HARBOR RD STE 302",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809406",
            "telephone_number": "856-278-6095",
            "fax_number": "866-567-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 EGG HARBOR RD STE 302",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809406",
            "telephone_number": "856-278-6095",
            "fax_number": "866-567-5687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017571750",
            "country_code": "US",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRONGOLO",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PSY.D., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2025-09-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynne Perno, MPT
• Louis P. Perri, MD
• Persante Sleep Care, Inc.
• Gregory Blase Persichetti, D.O.
• Jamie Petkovic, APN
• Thuyanh Ngoc Phan, N.P
• Pharmcierge
• Philadelphia Vamc
• Phillips Chiropractic Centre
• David Phillips, D.C.

• Behavior Analyst in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.