Courtney Petley, LCSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0904006775 Issued in VA

Practice address

4318 Boones Bluff Way
Chesterfield, VA 23832-7694

Phone

(804) 339-6121

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

Yes

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

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Geropartners LLCGroup PAC ID 3072804954, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Geropartners LLC

  • Community/Behavioral Health Agency
  • Chesterfield, VA
  • NPI 1710360169

  VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1841672201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 BOONES BLUFF WAY",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238327694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 BOONES BLUFF WAY",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238327694",
            "telephone_number": "804-339-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETLEY",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0904006775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Peers, LCSW
• Claudia Perez
• Perseverance in Spite of Adversity
• Ramona Peters, LCSW
• Jarvarius Peterson, PTA
• Thomas P Petrey, LCSW
• Dennis Petrocelli, MD
• Joseph Pfab, DDS
• Michael D Pfab, D.D.S.
• Phoenix Medical Transportation LLC

• All providers in Chesterfield, VA
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.