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Grace E Petty

Counselor

Behavioral Health & Social Service Providers

3410 Old Forest Rd, Lynchburg, VA 24501-2915

PECOS Enrollment

This provider is enrolled in PECOS as GRACE PETTY.

Based on the most recent information from CMS, provider Grace E Petty is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1427318369
Provider Type
Individual
Full Name
Petty, Grace E
Credential
MA LPC

Gender
Female
Sole Proprietor
No
Enumeration Date
5/25/2012
Last Updated
8/14/2015

Contact Information

Practice Location

3410 Old Forest Rd, Lynchburg, VA 24501-2915

(434) 455-1000

(434) 485-8877

Mailing Location

620 Court St, Lynchburg, VA 24504-1312

(434) 455-1000

(434) 485-8877

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701005872 Virginia
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 64798 Texas

Grace E Petty

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Strange, Sophia

Rosser, Patrice Montez

Harkins, Burks Overbey

Oglesby, Christine E

Caldwell, Pamela S

Crawford, Elizabeth Ann

Overstreet, Kelly

Ayers, Brittany

Worsham, Katherine

Martin, Shiloh