Petra Dajevic Gross, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701008498 Issued in VA

Practice address

700 Tech Center Pkwy Ste 200-17
Newport News, VA 23606-3075

Phone

(757) 690-1992

NPI assigned

Aug 6, 2019

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

Other names 1

• Ms. Petra Dajevic Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Peace'in'It Counseling

  • Mental Health Counselor
  • Newport News, VA
  • NPI 1518622075

  Professional

  NPD

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1982259032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 TECH CENTER PKWY STE 200-17",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063075",
            "telephone_number": "757-690-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 TECH CENTER PKWY STE 200-17",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063075",
            "telephone_number": "757-690-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "PETRA",
        "middle_name": "DAJEVIC",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETRA",
            "last_name": "DAJEVIC",
            "prefix": "MS.",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Grimshaw-Clark, LCSW
• James McCall Grimson, M.D.
• Steven Michael Griswold, M.D.
• John D Grizzard, M.D.
• Barry Lee Gross, MD
• Ashley Taylor Grubbs, LPC
• Guardian Light Home Health LLC
• Paul Guarino, M.D.
• Josselyn N Guevara Aguilera
• Shannon Lea Guichard, COTA/L

• Professional Counselor in Newport News, VA
• Providers in Newport News, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2021; 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.