Active NPI
David Brian Fetterman, M.A
- Mental Health Counselor
- New Ringgold, PA
National Provider Identifier
1710157169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PC001871
- Practice address
- 43 Red Oak Ter
New Ringgold, PA 17960-8927 - Phone
- (570) 386-5038
- NPI assigned
- Mar 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC001871 | PA | Primary |
Addresses
Primary practice location
43 Red Oak Ter
New Ringgold, PA 17960-8927
Mailing address
43 Red Oak Ter
New Ringgold, PA 17960-8927
Phone (570) 386-5038
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC001871 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204329600000",
"number": "1710157169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 RED OAK TER",
"city": "NEW RINGGOLD",
"state": "PA",
"postal_code": "179608927",
"telephone_number": "570-386-5038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 RED OAK TER",
"city": "NEW RINGGOLD",
"state": "PA",
"postal_code": "179608927",
"telephone_number": "570-386-5038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTERMAN",
"first_name": "DAVID",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "M.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-01",
"last_updated": "2008-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "PC001871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Ringgold, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.