Juanita Pettaway, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2203489 Issued in OH

Practice address

311 1/2 Conant St Ste 205
Maumee, OH 43537-3378

Phone

(567) 229-3467

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifeworthy LLC

  • Clinical Social Worker
  • Maumee, OH
  • NPI 1417573221
  NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OH

  Medicare reassignment

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1518338748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 1/2 CONANT ST STE 205",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435373378",
            "telephone_number": "567-229-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 1/2 CONANT ST STE 205",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435373378",
            "telephone_number": "567-229-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTAWAY",
        "first_name": "JUANITA",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Lynn Peters, SLP
• Michael E Peters, PT
• Scott Peters, OT
• Lauren L Peterson Jr., CRNA
• Aleeyah Pettaway, RBT
• Brandon Petty
• Peyton Care Professionals, LLC
• Joseph S Peyton, D.O.
• Rachel Lee Pfaff, FNP-C
• Pharmacy Counter, LLC

• Clinical Social Worker in Maumee, OH
• Providers in Maumee, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.