Active NPI
Holly Pettet
- School Psychologist
- Defuniak Springs, FL
National Provider Identifier
1730021775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS2001
- Practice address
- 640 Baldwin Ave
Defuniak Springs, FL 32435-2593 - Phone
- (850) 684-5739
- NPI assigned
- Apr 8, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SP00776 | OH | |
| School Psychologist | 103TS0200X | SS2001 | FL | Primary |
Addresses
Primary practice location
640 Baldwin Ave
Defuniak Springs, FL 32435-2593
Mailing address
152 This Way
Freeport, FL 32439-5435
Phone (850) 684-5739
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS2001 | FL | MD | School Psychologist |
| SP00776 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1730021775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 THIS WAY",
"city": "FREEPORT",
"state": "FL",
"postal_code": "324395435",
"telephone_number": "850-684-5739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 BALDWIN AVE",
"city": "DEFUNIAK SPRINGS",
"state": "FL",
"postal_code": "324352593",
"telephone_number": "850-684-5739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTET",
"first_name": "HOLLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-08",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "SP00776",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS2001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Defuniak Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.