Jessica Shannon Pettigrew, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09929444 Issued in CO

Practice address

1155 Kelly Johnson Blvd Ste 111
Colorado Springs, CO 80920-3957

Phone

(970) 316-2161

NPI assigned

May 29, 2018

Last updated

Oct 25, 2023By the provider in NPPES

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

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

State licenses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1508357336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD STE 111",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203957",
            "telephone_number": "970-316-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD STE 111",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203957",
            "telephone_number": "970-316-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "JESSICA",
        "middle_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253033",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09929444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Susan Petrone, LPC
• Lara Petropoulos
• Suzana Milorada Petrovic-Sweney, PTA
• Tamara Ann Petrowsky Gorman, MS, CCC-SLP
• Michael Petrucci, MD
• Kylee Pettit
• Aubree Petty, DC
• Molly Anne Petzl, LMT
• Stephanie M Pfeif, MA CCC-SLP
• Justin Pfeifer, DDS

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.