Grace Pettus
Counselor, Mental Health in Middletown, New York
1689542425- Practice location
- 15 Fortune RD W, Middletown, NY 10941-1625
- Phone
- 188-875-0226
- Fax
- —
- Last updated
- October 24, 2025
Grace Pettus is a Counselor, Mental Health based in Middletown, NY. Grace Pettus practices in Middletown, NY. The NPI Number for Grace Pettus is 1689542425 and holds a License No. P139398 (NY). The current practice location address for Grace Pettus is 15 Fortune RD W, Middletown, NY 10941-1625 and can be reached out via phone at 188-875-0226.
Provider Profile Details
- NPI Number
- 1689542425
- Provider Name
- Grace Pettus
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 15 Fortune RD W, Middletown, NY 10941-1625
- Phone Number
- 188-875-0226
- Primary Taxonomy
- Counselor, Mental Health · 101YM0800X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 24, 2025
- Last Update Date
- October 24, 2025
- Certification Date
- October 24, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 15 Fortune RD W
Middletown, NY 10941-1625 - City
- Middletown
- State
- New York
- Zip
- 10941-1625
- Phone Number
- 188-875-0226
Provider Business Mailing Address Details
- Address
- 15 Fortune RD W
Middletown, NY 10941-1625 - City
- Middletown
- State
- NY
- Zip
- 10941-1625
License Information
- License Number
- P139398
- License State
- NY
- Taxonomy
- Counselor, Mental Health · 101YM0800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Grace Pettus?
The NPI number of Grace Pettus is 1689542425. It was assigned on October 24, 2025 and is currently active in the NPPES registry.
What is the specialty of Grace Pettus?
Grace Pettus is registered under the primary taxonomy Counselor, Mental Health (code 101YM0800X), licensed in NY under license number P139398.
Where does Grace Pettus practice?
The practice location is 15 Fortune RD W, Middletown, NY 10941-1625. The office can be reached at 188-875-0226 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1689542425 directly on the NPPES registry website.