DR. WILLIAM DAVID PETOK PH.D.
NPI 1275607764
Psychologist in Severna Park, MD

Active since November 17, 2006PECOS EnrolledAccepts Medicare Assignment
479 JUMPERS HOLE RD, SUITE 304B, SEVERNA PARK, MD 21146(410) 647-9166(410) 647-9174 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. William David Petok Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WILLIAM DAVID PETOK PH.D. (NPI 1275607764) is an individual psychologist in Severna Park, Maryland, licensed in Maryland (1349) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1978).

NPPES Registry Identity

NPI1275607764
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. WILLIAM DAVID PETOKCredential: PH.D.
Location Address479 JUMPERS HOLE RD, SUITE 304BSeverna Park, MD 21146-1600
Mailing Address479 Jumpers Hole Rd, Suite 304bSeverna Park, MD 21146-1600 · (410) 647-9166 · Fax (410) 647-9174
Fax(410) 647-9174
Sole ProprietorYes
Medical School CMSOtherGraduated 1978
Enumeration DateNovember 17, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1275607764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MD · 1349
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
479 JUMPERS HOLE RD, Severna Park, MD 21146

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. William David Petok Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870782287
PECOS Enrollment IDI20110209000829
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
479 JUMPERS HOLE RD, SUITE 304B
SEVERNA PARK, MD 21146
Dentist (General Practice)
479 JUMPERS HOLE RD, SUITE 201
SEVERNA PARK, MD 21146
Psychologist (Clinical)
479 JUMPERS HOLE RD, SUITE 206
SEVERNA PARK, MD 21146
Dentist
479 JUMPERS HOLE RD, SUITE 201
SEVERNA PARK, MD 21146
Otolaryngology
479 JUMPERS HOLE RD, SUITE 304
SEVERNA PARK, MD 21146
Internal Medicine
479 JUMPERS HOLE RD, STE 304A BLAKESLEE & EICHELBERGER LLC
SEVERNA PARK, MD 21146
Otolaryngology (Facial Plastic Surgery)
479 JUMPERS HOLE RD, SUITE 304
SEVERNA PARK, MD 21146
Physician Assistant
479 JUMPERS HOLE RD, SUITE 304
SEVERNA PARK, MD 21146

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Petok's NPI number?

The NPI number for William Petok is 1275607764. It was assigned to this individual provider in the NPPES registry on November 17, 2006.

Where is William Petok located?

William Petok practices at 479 Jumpers Hole Rd Suite 304B, Severna Park, MD 21146. The listed phone number is (410) 647-9166.

What is William Petok's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is William Petok enrolled in Medicare?

Yes. William Petok is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for William Petok was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.