Theresa Pettaway, PCD,DONA

Primary specialty

DoulaTaxonomy code 374J00000X

License

18087 Issued in PA

Practice address

624 Mason Ave
Drexel Hill, PA 19026-2430

Phone

(610) 553-5481

Fax

(610) 553-5482

NPI assigned

Apr 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Pettaway Pursuit Foundation

  • Doula
  • Upper Darby, PA
  • NPI 1154857589
  NPD Authorized official

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1447784236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 MASON AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190262430",
            "telephone_number": "610-553-5481",
            "fax_number": "610-553-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 MASON AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190262430",
            "telephone_number": "610-553-5481",
            "fax_number": "610-553-5482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7408 W Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Upper Darby",
            "state": "PA",
            "postal_code": "190822006",
            "country_code": "US",
            "telephone_number": "610-553-5481",
            "fax_number": "610-553-5482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTAWAY",
        "first_name": "THERESA",
        "credential": "PCD,DONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "PA",
            "license": "18087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233089455",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043794560002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Perni
• Maura Perni, PT, DPT, OCS
• Peter L. King D.P.M.
• Rashina Peterkin
• Brooke Petrucci, DPT
• Thien Phan
• Philadelphia Concussion Specialists
• Philadelphia Dental Laser & Cosmetic Dentistry LLC
• Philadelphia Support Services and Management
• Philip Shin DDS LLC

• Doula in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Doula in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.