Mia Pettit, LCSW, CCDP-D, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q1-0001164 Issued in DE

Practice address

600 N Broad St Ste 5No715
Middletown, DE 19709-1032

Phone

(302) 526-0946

NPI assigned

Nov 15, 2012

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

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mia.pettit@489656322949124.direct.elationemr.com

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DE

  Medicare reassignment NPD
• Delaware Guidance Services for Children & Youth, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, DE
  • NPI 1992806186
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1972847028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 S STATE ST",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199341978",
            "telephone_number": "302-698-8410",
            "fax_number": "302-698-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N BROAD ST STE 5NO715",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091032",
            "telephone_number": "302-526-0946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2841 S State St",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "DE",
            "postal_code": "199341978",
            "country_code": "US",
            "telephone_number": "302-698-8410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "MIA",
        "credential": "LCSW, CCDP-D, CAADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Perillo
• Perrykel Health Services LLC
• Brandon Michael Petersen, DC
• Marie Guirlene Petion
• Raymond Petkevis
• Kim Phuong Pham
• Mannpreet Phambri-Komal, M.D.
• Michael Phillips, LAT, ATC
• Physiotherapy Associates - Union Rehab LLC
• Jennifer R Piaskowski, WHNP

• Clinical Social Worker in Middletown, DE
• Providers in Middletown, DE by specialty
• Clinical Social Worker in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.