Dominick A. Petitto, MS, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC012936 Issued in PA

Practice address

3 W Olive St
Scranton, PA 18508-2572

Phone

(570) 291-8449

NPI assigned

Jan 25, 2021

Sex

Male

Sole proprietor

Yes

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

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1467042390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 PROSPECT AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185051428",
            "telephone_number": "516-220-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W OLIVE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "570-291-8449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "223 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185051428",
            "country_code": "US",
            "telephone_number": "516-220-8780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETITTO",
        "first_name": "DOMINICK",
        "middle_name": "A.",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Perry
• Kimberly Aneila Persaud Shewnarain, DO
• Personal Promise Homecare, LLC.
• John William Peters, MD
• Laura Peters, PA-C
• Susan Petokas, CRNP
• Jessica Petrilak
• Mark Petrole, RN
• Scott J. Pettinato, D.M.D.
• Dana Pezzuti, MSOTR/L

• Professional Counselor in Scranton, PA
• Providers in Scranton, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.