Rebecca Marie Petty, MA INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

614 Peterson Rd
Burlington, WA 98233-2606

Phone

(360) 676-2164

Fax

(360) 676-2144

NPI assigned

Mar 20, 2014

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Catholic Community Services of Western Washington

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bellingham, WA
  • NPI 1548332190
  NPD (past)

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1518384148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 RAILROAD AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255055",
            "telephone_number": "360-676-2164",
            "fax_number": "360-676-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 PETERSON RD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982332606",
            "telephone_number": "360-676-2164",
            "fax_number": "360-676-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "MA INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "60583009",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juleen Perusek
• Fritz Charles Peterson, CDP(T)
• Sarah Peterson, LMT
• Sierra Peterson
• Elle Marie Petrie
• Susan Pfau
• Brianna A Piazza
• Pioneer Human Services
• Amanda Elisabeth Plummer, LMP
• Raymond A Powell, OD

• Mental Health Counselor in Burlington, WA
• Providers in Burlington, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.