Nathan Samuel Pettit, MS, LMHC, MCAP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

22796 Issued in FL

Practice address

2442 Laurentina LN
Cape Coral, FL 33909-5280

Phone

(239) 240-2121

NPI assigned

Mar 11, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Credentials

Master of Science

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.

• Direct Access Counseling & Supportive Services, LLC

  dba Direct Access Counseling and Supportive Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, FL
  • NPI 1679011449

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  FL

  Medicare reassignment NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695427200000",
    "number": "1952986952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 LAURENTINA LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095280",
            "telephone_number": "239-240-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 LAURENTINA LN",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095280",
            "telephone_number": "239-240-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "NATHAN",
        "middle_name": "SAMUEL",
        "credential": "MS, LMHC, MCAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-11",
        "last_updated": "2023-09-23",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "22796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dirk Peterson, M.D.
• Kenya Peterson
• Revonda D Peterson, ARNP
• Erica Petithomme
• Kathie-Lee Petsch, CCC-SLP
• Gabrielle Pfeffer
• Ngoc Han Thi Pham, DPM
• Tan-Long Pham, MS, OD
• Thomas S Pham, MD
• Nhi Thi-Hong Phan, MD

• Mental Health Counselor in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2023; 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.