Robert Alan Petry, LICENSED CLINICAL PS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810002340 Issued in VA

Practice address

6964 Forest Hill Ave
Richmond, VA 23225-1659

Phone

(804) 320-7738

Fax

(804) 320-8738

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Elizabeth a Brill PHD LCP

  • Counseling Psychologist
  • Richmond, VA
  • NPI 1417247909
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1790874154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6964 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251659",
            "telephone_number": "804-320-7738",
            "fax_number": "804-320-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6964 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251659",
            "telephone_number": "804-320-7738",
            "fax_number": "804-320-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRY",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "credential": "LICENSED CLINICAL PS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700199",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larisa Petrie, AGACNP-BC
• Steven Petritz
• Rachel Quinn Petrohovich, PA-C
• Frank D. Petruzella, M.D.
• Annelise Arceneaux Petry, LCSW
• Richard Joseph Pettit, MD
• Carlton Heath Petty, M.D.
• Ena Pettyjohn, FNP-C
• Benjamin Franklin Petway
• Madalyn Peyton, LCSW

• Clinical Psychologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.