Petra Betterton, LPCMH
Individual provider Active NPI Mental Health Counselor · Newark, DE
NPI 1497464986 · NPPES record last updated Nov 23, 2022
Key facts
- NPI
- 1497464986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- PC-011259 (DE)
- Practice address
- 403 Shue Dr
Newark, DE 19713-1745 - Phone
- (808) 551-7761
- NPI assigned
- Nov 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240703000364 | DE | Practitioner - Mental Health Counselor | 9537507660 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC-011259 | DE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
Locations
200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | PC-011259 | DE | Yes |
Addresses
Primary practice location
403 Shue Dr
Newark, DE 19713-1745
Mailing address
403 Shue Dr
Newark, DE 19713-1745
Phone (808) 551-7761
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- Amy Beukema
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All providers in Newark, DE · Mental Health Counselor in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.