Darius D Pettway

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

68071 Issued in TX

Practice address

PO Box 210061
Dallas, TX 75211-0061

Phone

(214) 945-0642

NPI assigned

Apr 19, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Darius Pettway Life Skool Corporation

  dba Life Skool

  • Case Management Agency
  • Dallas, TX
  • NPI 1457033888
  NPD Authorized official

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1841045176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210061",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752110061",
            "telephone_number": "214-945-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 210061",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752110061",
            "telephone_number": "214-945-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "DARIUS",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "68071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice M Pettis-Ingram, ED.D, LLC
• Heidi Nicole Pettit, RN, CPNP - PC
• James L. Pettit, LPC
• Larry A Pettit, DO
• Emily Pettke, CRNA
• Yasminye Deangella Pettway
• Asia Petty
• Kara Deanne Petty, FNP-C
• Karyn Petty, RN AGACNP
• Morgan Petty, DDS

• Addiction (Substance Use Disorder) Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.