Michelle L Petty, M.S., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH12590 Issued in FL

Practice address

1412 Tech Blvd
Tampa, FL 33619-7865

Phone

(813) 635-9765

NPI assigned

Sep 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Camelot Community Care, Inc

  • Foster Care Agency
  • Tampa, FL
  • NPI 1619225679
  NPD (past)
• Camelot Community Care, Inc

  • Foster Care Agency
  • Tampa, FL
  • NPI 1639406093
  NPD (past)

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1578812533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 TECH BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197865",
            "telephone_number": "813-635-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 TECH BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197865",
            "telephone_number": "813-635-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "M.S., LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Nicole Pettenger, PA-C
• Erika Sue Pettinato, D.M.D., M.S.
• Jason Pettit, RBT
• Matthew J Pettit, APRN
• Meta Lashon Petty, LCSW
• Janet Sue Pettyjohn, D.O.
• Justin Lee Pevner, MD
• Elaine A Peyno
• Carmen Peyton, R.N.F.A.
• Michelle Elizabeth Pezo, PA-C

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.