Theo A Petrocci, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701000926 Issued in VA

Practice address

16 Walnut Ave SW
Roanoke, VA 24016-4719

Phone

(540) 345-6468

Fax

(540) 345-3204

NPI assigned

Jun 21, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922003458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GROVE AVE",
            "address_2": "STE 102",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232212220",
            "telephone_number": "804-822-0271",
            "fax_number": "804-353-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WALNUT AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164719",
            "telephone_number": "540-345-6468",
            "fax_number": "540-345-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCCI",
        "first_name": "THEO",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701000926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005401437",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David West Peterson, TH.M., L.P.C.
• Jennifer M Peterson, DO
• Maggie Marie Peterson, BCBA
• Rebecca Dawn Peterson, COTA/L
• Toni Petrillo, MD
• Jessica Allen Petry
• Kyle D Pfaff, DO
• Jacob H. Pham, D.D.S.
• Long-Quan Duc Pham
• Paula Pham

• Mental Health Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.