Joseph Daniel Petruso, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904000087 Issued in VA

Practice address

124 Amherst St
Winchester, VA 22601-4114

Phone

(540) 667-6272

Fax

(540) 542-0406

NPI assigned

Feb 7, 2006

Last updated

Jun 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Shenandoah Family Institute, Inc.

  • Community/Behavioral Health Agency
  • Winchester, VA
  • NPI 1952527095
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1558333021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014114",
            "telephone_number": "540-667-6272",
            "fax_number": "540-542-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014114",
            "telephone_number": "540-667-6272",
            "fax_number": "540-542-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUSO",
        "first_name": "JOSEPH",
        "middle_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904000087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "087912",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8937931",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Peterson
• Wesley Peterson, MD
• Amber Petree, RD
• Justin D Petri, MD
• Andrew Scott Petrucci, PHYSICAL THERAPIST
• Angela Dawn Petry, N.P.-C
• Danika Lucia Pfeiffer, M.S., CCC-SLP
• Jessica Inthavongxay Pfrommer, DPM
• Hanh Pham
• Margaret Pham

• Mental Health Counselor in Winchester, VA
• Providers in Winchester, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.