Laura Petiford, PMHNP, LMFT

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

006417 Issued in CT

Practice address

1525 Kings Hwy
Suite 206
Fairfield, CT 06824-5321

Phone

(203) 445-6238

NPI assigned

Apr 28, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jewish Family Service of Stamford, Inc.

  • Clinical Social Worker
  • Stamford, CT
  • NPI 1346291861

  Marriage & Family Therapist

  Medicare reassignment NPD
• Laura Petiford Pmhnp, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfield, CT
  • NPI 1083110092
  NPD Authorized official
• Connecticut Psychiatric & Wellness Center

  • Community/Behavioral Health Agency
  • Woodbridge, CT
  • NPI 1174902084
  NPD (past)

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1689818148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BEAUMONT ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 KINGS HWY",
            "address_2": "SUITE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245321",
            "telephone_number": "203-445-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIFORD",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "PMHNP, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001309",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "006417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Macario Perry, PT, DPT, CSCS
• Peter a. Small, M.D., PC
• Anne Peterlin
• Jennifer Peterson, OTR/L
• Susan Gibson Peterson, M.S.W.L.C.S.W.
• Christopher Petrosino
• Rebecca Lynne Petrosino, PT
• Andrea Pezzimenti, PTA
• Amy Philosoph, OT
• Physical Synergy, LLC

• Psychiatric/Mental Health Nurse Practitioner in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.