Rebecca Anne Petrie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069758 Issued in NY

Practice address

339 Old Town Rd
East Setauket, NY 11733-3450

Phone

(631) 828-8157

NPI assigned

Jul 6, 2011

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

Other names 1

• Ms. Rebecca Anne Norton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1861789273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 OLD TOWN RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333450",
            "telephone_number": "631-828-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 OLD TOWN RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333450",
            "telephone_number": "631-828-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "NORTON",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Peskin-Stolze, M.D.
• David L Peters, D.O.
• Matthew Petersen, P.A.
• Michael James Petersen, M.D.
• Douglas Matthew Petraco, MD
• Thomas Joseph Pettei, M.D.
• Jedan Phillips, M.D.
• Antonia Michelle Pinto, NP
• Marie Florence Placide-Eugene, RN
• Alyssa M Policastro, CPNP-PC

• Clinical Social Worker in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.