DR. JAMIE RAY PETTIT ED.D LPC - MHSP NPI 1003371667

NPI Information

  • NPI: 1003371667
  • Provider Name: DR. JAMIE RAY PETTIT, ED.D LPC - MHSP
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6401 POPLAR AVE STE 500
    MEMPHIS, TN
    ZIP 38119
  • Phone: (901) 746-9438

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NPI Details

DR. Jamie Ray Pettit, ED.D LPC - MHSP is a professional counselor in Memphis, TN. DR. Jamie Ray Pettit, ED.D LPC - MHSP NPI is 1003371667. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6401 POPLAR AVE STE 500
MEMPHIS, TN
ZIP 38119-808
Phone: (901) 746-9438
Fax: (901) 410-4536

The NPI 1003371667 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 2/7/2019 and was last updated on 8/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health2300TENNESSEENo
2101YP2500XCounselorProfessional2300TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100002300OTHERTENNESSEELPC NUMBER
2Q051103MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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