Individual provider Active NPI

Nadege Petrie

  • Mental Health Counselor
  • Newberg, OR
National Provider Identifier
1730600057
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2855 E Hayes St
Newberg, OR 97132-1397
Phone
(786) 471-6697
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2855 E Hayes St
Newberg, OR 97132-1397

Mailing address

505 S Chehalem St
Newberg, OR 97132-3621
Phone (786) 471-6697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410001900 OR Practitioner - Mental Health Counselor 8123466208 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hopeful Minds Counseling Services - Corp CurrentSince Jan 1, 2024 Accepting new patients
Hopeful Minds Counseling Services LLC CurrentSince Feb 1, 2022 Accepting new patients
Hopeful Minds Counseling Services - Corp Mental Health Current Accepting new patients

Locations

1308 E 1st St
Ste 3
Newberg, OR 97132
Phone (503) 550-6862

2855 E Hayes St
Newberg, OR 97132
Phone (503) 487-6732

720 Seneca St
Ste 107
Seattle, WA 98101
Phone (206) 593-2882

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1730600057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S CHEHALEM ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971323621",
            "telephone_number": "786-471-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 E HAYES ST",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321397",
            "telephone_number": "786-471-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "NADEGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.