Active NPI
Carla Petree
- Mental Health Counselor
- Palmetto, FL
National Provider Identifier
1811384381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH15954
- Practice address
- 600 8TH Ave W Ste 200
Palmetto, FL 34221-5162 - Phone
- (941) 807-2670
- NPI assigned
- Apr 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH15954 | FL | Primary |
Addresses
Primary practice location
600 8TH Ave W Ste 200
Palmetto, FL 34221-5162
Mailing address
9952 Hyde Glen CT
Charlotte, NC 28262-2659
Other practice location 1
6228 Kevesta Ave
Palmetto, FL 34221-2576
Phone (954) 326-2274
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56-0554413 | Medicaid | NC | |
| 1811384381 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | carlapetree@shekinahcounseling.org | Direct |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH15954 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1811384381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9952 HYDE GLEN CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282622659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 8TH AVE W STE 200",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342215162",
"telephone_number": "941-807-2670"
}
],
"practiceLocations": [
{
"address_1": "6228 Kevesta Ave",
"address_purpose": "LOCATION",
"city": "Palmetto",
"state": "FL",
"postal_code": "342212576",
"country_code": "US",
"telephone_number": "954-326-2274",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETREE",
"first_name": "CARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-22",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH15954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56-0554413",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811384381",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "carlapetree@shekinahcounseling.org",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "600 8th Ave W Ste 200",
"city": "Palmetto",
"state": "FL",
"country_code": "US",
"postal_code": "342215162",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Palmetto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.