Kathleen L Petulla, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW014722 Issued in PA

Practice address

5000 McKnight Rd Ste 202
Pittsburgh, PA 15237-3420

Phone

(412) 366-8342

NPI assigned

Apr 26, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• New Directions Counseling Services, LLC

  • Psychologist
  • Wexford, PA
  • NPI 1548373541
  NPD (past)
• Supporting You Counseling and Consulting

  • Clinical Social Worker
  • Gibsonia, PA
  • NPI 1811676711
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1700843737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 CIDER MILL DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449284",
            "telephone_number": "412-889-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MCKNIGHT RD STE 202",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152373420",
            "telephone_number": "412-366-8342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5424 William Flynn Hwy",
            "address_purpose": "LOCATION",
            "city": "Gibsonia",
            "state": "PA",
            "postal_code": "150449652",
            "country_code": "US",
            "telephone_number": "412-889-2333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETULLA",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1434077",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "493578000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Michael Petti, D.M.D.
• Corbin Cassidy Pettigrew
• Christina Pettinato, CHRISTINA PETTINATO
• Erin Marie Pettinger, MS.ED, ATC
• Kelly L Pettko, RPH
• Jamie Cohen Peven, PHD
• Dominic Pezzone, D.O.
• Michael Angelo Pezzone, MD
• Glenn C Pfeffer, PT
• Renee A Pfeiffer, CRNP

• Clinical Social Worker in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.