Active NPI
Nicholas Joel Petrucelli, CAC III
- Addiction (Substance Use Disorder) Counselor
- Commerce City, CO
National Provider Identifier
1538461124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 6919
- Practice address
- 7251 E 49TH Ave
Commerce City, CO 80022-4714 - Phone
- (303) 468-6191
- Fax
- (303) 321-3556
- NPI assigned
- Dec 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6919 | CO | Primary |
Addresses
Primary practice location
7251 E 49TH Ave
Commerce City, CO 80022-4714
Mailing address
7251 E 49TH Ave
Commerce City, CO 80022-4714
Phone (303) 468-6191
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 |
|---|---|---|---|
| 6919 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389571200000",
"number": "1538461124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7251 E 49TH AVE",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "800224714",
"telephone_number": "303-468-6191",
"fax_number": "303-321-3556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7251 E 49TH AVE",
"city": "COMMERCE CITY",
"state": "CO",
"postal_code": "800224714",
"telephone_number": "303-468-6191",
"fax_number": "303-321-3556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRUCELLI",
"first_name": "NICHOLAS",
"middle_name": "JOEL",
"name_prefix": "Mr.",
"credential": "CAC III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-02",
"last_updated": "2014-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "6919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commerce City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.