Chad Petrulis, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55290

Practice address

316 W Front St
Livingston, MT 59047-1925

Phone

(406) 223-2097

NPI assigned

Mar 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chad.petrulis@alumni.brescia.edu

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MT

  Medicare reassignment NPD

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1992452056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W FRONT ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590471925",
            "telephone_number": "406-223-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W FRONT ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590471925",
            "telephone_number": "406-223-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRULIS",
        "first_name": "CHAD",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "55290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Chad.petrulis@alumni.brescia.edu",
            "affiliation": "N",
            "address_1": "316 W Front St",
            "city": "Livingston",
            "state": "MT",
            "country_code": "US",
            "postal_code": "590471925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Park Health Care PLLC
• Partnership for Health & Wellness, Inc.
• Shawn Glenn Patrick, PHARM D
• PCRS 360 Dba Rural Resilience
• Amy Jacquelin Petrulis, M.S., L.C.S.W.
• Caroline Lamar Pihl, MD
• Henry Pinango, MD
• Kyra E Pinango, M.D.
• Lindsey Pippin, MBA, LBA
• Chantelle Plauche', MSW, LCSW

• Clinical Social Worker in Livingston, MT
• Providers in Livingston, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.