MR. KENNETH MICHAEL PETTIS JR. LMFT
NPI 1699485540
Marriage & Family Therapist in Lodi, CA
NPI Status: Active since December 01, 2022
Contact Information
315 W PINE ST #3, 95240
LODI, CA
ZIP 95240
Phone: (209) 366-2273
- Individual
- Male
- Marriage & Family Therapist
- PECOS Enrolled
About KENNETH PETTIS
This page provides the complete NPI Profile along with additional information for Kenneth Pettis, a provider established in Lodi, California with a medical specialization in Marriage & Family Therapist. The healthcare provider is registered in the NPI registry with number 1699485540 assigned on December 2022. The practitioner's primary taxonomy code is 106H00000X with license number 150072 (CA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1699485540
- Provider Name
- MR. KENNETH MICHAEL PETTIS JR. LMFT
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 315 W PINE ST #3, 95240 LODI, CA 95240
- Location Phone
- (209) 366-2273
- Mailing Address
- 5250 CLAREMONT AVE STE 118 STOCKTON, CA 95207
- Mailing Phone
- (719) 200-2238
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-01-2022
- Last Update Date
- 10-15-2024
- Code Navigator
A marriage and family therapist like Kenneth Pettis help patients manage problems with their family and other relationships. Marriage and family therapists encourage clients to discuss their emotions and experiences and, develop strategies and skills to change behavior and cope with difficult situations. Many therapists apply cognitive behavioral therapy to help patients understand harmful thoughts, feelings, and also teach patients how to replace them with positive, life-enhancing ones.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Marriage & Family Therapist
- Taxonomy Code
- 106H00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 150072
- License State
- CA
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Kenneth Pettis is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for MR. KENNETH MICHAEL PETTIS JR. LMFT
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 9 | 9 | 4 | 8 | 5 | 5 | 4 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 18 | 9 | 8 | 8 | 10 | 5 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 8 + 9 + 8 + 8 + 1 + 0 + 5 + 8 + 24 = 80 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1699485540 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699485540, enumerated in the NPI registry as an "individual" on December 01, 2022
The provider is located at 315 W Pine St #3, 95240 Lodi, Ca 95240 and the phone number is (209) 366-2273
The provider's speciality is Marriage & Family Therapist with taxonomy code 106H00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
This NPI record was last updated on December 01, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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