Carol Petok, PH.D., L.C.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC2728 Issued in MD

Practice address

770 Port St
Easton, MD 21601-8102

Phone

(410) 819-3395

Fax

(410) 770-5813

NPI assigned

May 21, 2008

Last updated

Mar 29, 2011By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1891952339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S WASHINGTON ST",
            "address_2": "#1006",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014351",
            "telephone_number": "410-770-5813",
            "fax_number": "410-770-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PORT ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018102",
            "telephone_number": "410-819-3395",
            "fax_number": "410-770-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETOK",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "PH.D., L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774800100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin Perry, BCTM, LMT, CLT
• Rebecca Lynn Pertain, MS CCC-SLP
• Peter H Niebyl, M.D.PA.
• Peter L Whitesell MD PA
• Helen Ann Petersen, COTA
• Lisa Marie Petroske
• Katharine Lloyd Parsons Petzold, LCSW-C
• Meredith Pfister
• Christine A Phillips, MD
• Irving Mace Phillips Jr., DDS

• Professional Counselor in Easton, MD
• Providers in Easton, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.