JERELL AKEEM PETTWAY
NPI 1700341476
Marriage & Family Therapist in Los Angeles, CA

Q: What is Jerell Pettway's NPI number?

The NPI number for Jerell Pettway is 1700341476. It was assigned to this individual provider in the NPPES registry on February 6, 2019.

Q: What is Jerell Pettway's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerell Pettway was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since February 06, 2019

3850 CRENSHAW BLVD, LOS ANGELES, CA 90008(323) 751-3026 Get Directions Write a Review

NPPES record last updated: October 11, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 11, 2023, Apr 10, 2023, Apr 1, 2019 and 1 more (4 updates tracked since 2019).

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About Jerell Akeem Pettway NPPES

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

JERELL AKEEM PETTWAY (NPI 1700341476) is an individual marriage & family therapist in Los Angeles, California, licensed in California (137903) and active in the NPI registry since February 2019. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1700341476

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameJERELL AKEEM PETTWAY

Location Address3850 CRENSHAW BLVDLos Angeles, CA 90008-1821

Mailing Address3850 Crenshaw BlvdLos Angeles, CA 90008-1821 · (323) 751-3026

Phone(323) 751-3026

Sole ProprietorYes

Enumeration DateFebruary 6, 2019

Last NPPES UpdateOctober 11, 20234 updates tracked since enumeration

NPPES CertifiedOctober 11, 2023

✔ NPI 1700341476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 137903

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

3850 CRENSHAW BLVD, Los Angeles, CA 90008

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Secondary Practice Locations 2

Location 11328 2nd StSanta Monica, CA 90401-1122 · Phone (310) 394-6889

Location 2108 W Victoria StGardena, CA 90248-3523 · Phone (310) 715-2020

Other Providers at the Same Location NPPES 20

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

SAMANTHA GURTH

Social Worker (Clinical)