Ivy S Pellerito, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

20004023896 Issued in MO

Practice address

229 NW Blue Pkwy Ste B
Lees Summit, MO 64063-1800

Phone

(816) 427-1828

NPI assigned

Mar 3, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Refresh Wellness & Counseling LLC

  • Professional Counselor
  • Lees Summit, MO
  • NPI 1922657477
  NPD (past) Authorized official

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

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1710228697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 NW BLUE PKWY STE B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631800",
            "telephone_number": "816-427-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 NW BLUE PKWY STE B",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631800",
            "telephone_number": "816-427-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERITO",
        "first_name": "IVY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-03",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "20004023896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla R Pearman, M.D.
• James David Pearson, PHARM D
• Pediatric Dental Specialists, PA
• Pediatric Professionals
• Alicia Ellis Peery, LPC
• Christopher Pelton, FNP-C
• Jessica Pemberton, M.ED, BCBA, LBA
• Melinda Dawn Pendergraft, CRNA
• Kelly B. Pendergrass, M.D.
• Kayla Pennington, DDS

• Professional Counselor in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.