Natifa Pettus, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009093 Issued in NC

Practice address

302 Bradford Ave
Fayetteville, NC 28301-5406

Phone

(910) 484-0095

Fax

(919) 238-7287

NPI assigned

Oct 17, 2012

Sex

Female

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

Enrolled in NC

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

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.

• Compassionate Counseling Services LLC

  • Mental Health Counselor
  • Rockingham, NC
  • NPI 1689946840
  NPD

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1891048757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BRADFORD AVENUE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-484-0095",
            "fax_number": "919-238-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BRADFORD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015406",
            "telephone_number": "910-484-0095",
            "fax_number": "919-238-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTUS",
        "first_name": "NATIFA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin James Petro, LPC
• Emily Elizabeth Petrucci, MS, CCC-SLP
• Rocco Petruolo, R N
• Audrey Petteruti, DO
• Josie Lynn Pettipiece, MS, CCC-SLP
• Angela D Petty, LMFT
• Maggie Marie Petty, DPT
• Emily Becker Pevtsov, PA-C
• Yonesha Val Phair, D.D.S
• My Pham, PHARMD

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.