NPIMap

Individual provider Active NPI

John Paul Fretheim, LCSW

  • Marriage & Family Therapist
  • Petersburg, VA
National Provider Identifier
1629034046
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0904000312 Issued in VA
Practice address
510 S Sycamore St
Suite F
Petersburg, VA 23803-5044
Phone
(804) 861-0700
Fax
(804) 863-4626
NPI assigned
Apr 25, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0904000312 VA
Addiction (Substance Use Disorder) Counselor 101YA0400X 0904000312 VA
Mental Health Counselor 101YM0800X 0904000312 VA
Marriage & Family Therapist 106H00000X 0904000312 VA Primary

Addresses

Primary practice location

510 S Sycamore St
Suite F
Petersburg, VA 23803-5044

Mailing address

510 S Sycamore St
Suite F
Petersburg, VA 23803-5044
Phone (804) 861-0700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904000312VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Treatment Center LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629034046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S SYCAMORE ST",
            "address_2": "SUITE F",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035044",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S SYCAMORE ST",
            "address_2": "SUITE F",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035044",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRETHEIM",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0904000312",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0904000312",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904000312",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0904000312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.