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John D. Petry , LPCC

Counselor - Professional β€’ Springfield, OH

Active NPI 1104108323 Individual Practitioner Male Practitioner
Practice location in NPPES

474 N Yellow Springs St
Springfield, OH 455042463

Call 9373999500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

474 N Yellow Springs St

Springfield, OH 455042463

Telephone 9373999500
Organization at the Same NPPES Address or Phone
Mental Health Services For Clark And Madison Counties Inc Facility NPI 1003074964

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Moraine, OH. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Springfield and Ohio

57 active clinicians are listed under Counselor - Professional with a practice address in Springfield, OH (6,790 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Springfield

1.8% of these 57 clinicians have the CMS telehealth indicator.

15.8% of these 57 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES OH E.1000175
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Secondary Practice Locations

2621 Dryden Rd Ste 300

Moraine, OH 454391600

Phone: 9374794828

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Fawzia Toor , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1063576056

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location November 11, 2019

Registered at 474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 455042463 (Tel: 9373999500)

πŸ“
Updated Practice Location June 05, 2019

Registered at 2621 DRYDEN RD STE 300, MORAINE, OH 454391600 (Tel: 9374794828)

πŸ‘€
Provider Name / Credentials Updated June 05, 2019

Recorded as JOHN PETRY, LPCC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2019

Counselor (license number reported to NPPES: OH E.1000175)

βœ…
NPI Profile Active September 22, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 22, 2011

Registered at 5450 FAR HILLS AVE, KETTERING, OH 454292386 (Tel: 9374794828)

πŸ“
Business Mailing Address (Initial Record) September 22, 2011

Registered at 2781 HILTON DR, KETTERING, OH 454091752 (Tel: 9374794828)

πŸ‘€
Provider Name / Credentials (Initial Record) September 22, 2011

Recorded as JOHN PETRY, PC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2011

Counselor (license number reported to NPPES: OH C.1000175)

🟒
Initial NPI Registration & Enumeration September 14, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1104108323
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 14, 2011
Last Update: November 11, 2019
Sole Proprietor: Yes

Mailing Address

2781 Hilton Dr

Kettering, OH 454091752

Phone: 9374794828

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.