Seqouia Jabre Pettigrew

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701012849 Issued in VA

Practice address

2150 Country Club Rd Ste 228
Winston Salem, NC 27104-4241

Phone

(855) 284-7483

Fax

(617) 807-0958

NPI assigned

Sep 20, 2021

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

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fredericksburg Area HIV/AIDS Support Services (Fahass)Group PAC ID 8628495116, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: seqouia.pettigrew.1@20704.direct.athenahealth.com

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.

• Fredericksburg Area Health and Support Services

  • Family Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1104170398
  Medicare reassignment Care Compare group NPD
• Petti Pathways Counseling

  • Mental Health Counselor
  • Fredericksburg, VA
  • NPI 1134835622
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1730859869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JEFFERSON ST STE 2C",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041724",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 COUNTRY CLUB RD STE 228",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044241",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "SEQOUIA",
        "middle_name": "JABRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701012849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Petrola, DDS
• Ashley Petronzio, IBCLC
• Milan Petrovic
• Patricia Harper Petrozza, MD
• Portia Pettigrew
• Heather L Pettit-Mee, M.A., CFY-SLP/L
• Elvy Pettit Jr., P.A.
• Danielle Robinson Petty, D.O.
• John K Petty, MD
• William Jeffrey Petty Jr.

• Professional Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.