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Michael Pettis, LCSW
NPI 1104036821 · Clinical Social Worker · Tupelo, MS
Michael Pettis, LCSW is a Clinical Social Worker provider in Tupelo, MS (NPI 1104036821).
Provider details
- NPI number
- 1104036821
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- C7971 (MS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
499 Gloster Creek Vlg
Suite D-1
Tupelo, MS 38801-4600
Phone: (662) 842-4651
Fax: (662) 842-7335
Approximate (ZIP-level) locationGet directions
Mailing address
499 Gloster Creek Vlg
Tupelo, MS 38801-4600
Registry dates
- Enumerated
- 2007-05-23
- Last updated
- 2015-05-04
Frequently asked questions
- What is Michael Pettis's NPI number?
- Michael Pettis's National Provider Identifier (NPI) is 1104036821, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Michael Pettis's specialty?
- Michael Pettis is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Michael Pettis located?
- Michael Pettis's practice location on file with NPPES is 499 Gloster Creek Vlg, Tupelo, MS 38801-4600.
- What is Michael Pettis's phone number?
- The practice phone number listed in the NPPES registry for Michael Pettis is (662) 842-4651.
- Is Michael Pettis's NPI active?
- Yes — Michael Pettis's NPI (1104036821) is active in the NPPES registry as of the last update on 2015-05-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.