Individual provider Active NPI

Andrea Marie Petrovich, LMHC

  • Mental Health Counselor
  • Sebring, FL
National Provider Identifier
1639181548
Registry record updated Feb 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH6732 Issued in FL
Practice address
102 S Ridgewood Dr Ste 7
Sebring, FL 33870-3300
Phone
(863) 359-9539
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH6732 FL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2390 FL

Addresses

Primary practice location

102 S Ridgewood Dr Ste 7
Sebring, FL 33870-3300

Mailing address

102 S Ridgewood Dr Ste 7
Sebring, FL 33870-3300
Phone (863) 359-9539

Other identifiers 1

IdentifierTypeStateIssuer
761879400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417002750 FL Practitioner - Mental Health Counselor 2961927348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

102 S Ridgewood Dr
Sebring, FL 33870-3300
Phone (863) 359-9539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2390FLMDAddiction (Substance Use Disorder) Counselor
MH6732FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling of Florida, LLC Mental Health CurrentSince Feb 2, 2025 Accepting new patients

Locations

102 S Ridgewood Dr
Ste 7
Sebring, FL 33870
Phone (863) 359-9539

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739059200000",
    "number": "1639181548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S RIDGEWOOD DR STE 7",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338703300",
            "telephone_number": "863-359-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S RIDGEWOOD DR STE 7",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338703300",
            "telephone_number": "863-359-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVICH",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2025-02-09",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6732",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "2390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761879400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.