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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 yesterday at 11:51 AM.

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

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