Active NPI
Jamie R. Petelin, LMFT 140485
- Mental Health Counselor
- Chico, CA
National Provider Identifier
1457600454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 109 Parmac Rd Ste 1
Chico, CA 95926-2294 - Phone
- (530) 891-2945
- NPI assigned
- Sep 5, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 140485 | CA | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
109 Parmac Rd Ste 1
Chico, CA 95926-2294
Mailing address
560 Cohasset Rd
Chico, CA 95926-2212
Phone (530) 891-2310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140485 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1457600454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 COHASSET RD",
"city": "CHICO",
"state": "CA",
"postal_code": "959262212",
"telephone_number": "530-891-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 PARMAC RD STE 1",
"city": "CHICO",
"state": "CA",
"postal_code": "959262294",
"telephone_number": "530-891-2945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETELIN",
"first_name": "JAMIE",
"middle_name": "R.",
"name_prefix": "Mrs.",
"credential": "LMFT 140485",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-05",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "140485",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.