Active NPI
Kimberly Jean Petrey, LGPC
- Mental Health Counselor
- Washington, DC
National Provider Identifier
1508536400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LGPC00859
- Practice address
- 915 Rhode Island Ave NW
Washington, DC 20001-4153 - Phone
- (202) 236-6100
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LGPC00859 | DC | Primary |
Addresses
Primary practice location
915 Rhode Island Ave NW
Washington, DC 20001-4153
Mailing address
5011 Caryn CT Apt 304
Alexandria, VA 22312-5060
Phone (740) 973-9533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGPC00859 | DC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1508536400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5011 CARYN CT APT 304",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223125060",
"telephone_number": "740-973-9533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 RHODE ISLAND AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200014153",
"telephone_number": "202-236-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREY",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"credential": "LGPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DC",
"license": "LGPC00859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.