NPIMap

Organization Active NPI

Petit Psychiatry

  • Child & Adolescent Psychiatry Physician
  • West Palm Beach, FL
National Provider Identifier
1982313508
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
PETIT PSYCHIATRY
Practice address
2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742
Phone
(561) 576-7879
Fax
(866) 450-1704
NPI assigned
Nov 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Ebony Petit, MDNPI 1447695184
Title
President
Phone
(205) 200-5110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742

Mailing address

2054 Vista Pkwy Ste 400
West Palm Beach, FL 33411-6742
Phone (561) 576-7879

Other practice location 1

1949 Gault Ave N Ste 104
Fort Payne, AL 35967-3483
Phone (561) 576-7879

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@petitpsychiatry.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230511003452 FL Part B Supplier - Clinic/Group Practice 6002272358 Receives reassigned benefits from 8 practitioners
Practice locations: Greenacres, FL

National Provider Directory

National Provider Directory

Locations

6801 Lake Worth Rd
Ste 204
Greenacres, FL 33467

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1982313508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 VISTA PKWY STE 400",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116742",
            "telephone_number": "561-576-7879",
            "fax_number": "866-450-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 VISTA PKWY STE 400",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334116742",
            "telephone_number": "561-576-7879",
            "fax_number": "866-450-1704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1949 Gault Ave N Ste 104",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359673483",
            "country_code": "US",
            "telephone_number": "561-576-7879",
            "fax_number": "866-450-1704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETIT PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2025-07-10",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "PETIT",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-200-5110",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@petitpsychiatry.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6801 Lake Worth Rd Ste 204",
            "city": "Greenacres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334672965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.