Ivy Petra, LCSW, LCAC
NPI 1538592704 · Clinical Social Worker · Goshen, IN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ivy Petra, LCSW, LCAC is a Clinical Social Worker provider in Goshen, IN (NPI 1538592704).
Provider details
- NPI number
- 1538592704
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW, LCAC
- Sex
- Female
- Sole proprietor
- No
- License
- 87001243A (IN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
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
Mailing address
Additional practice locations (3)
- 2600 Oakland AveElkhart, IN 46517-1533Phone: (574) 533-1234Fax: (574) 537-2652
- 2600 Oakland AveElkhart, IN 46517-1533Phone: (574) 533-1234Fax: (574) 537-2652
- 808 N 3rd StGoshen, IN 46528-7100Phone: (574) 534-0088Fax: (574) 971-8434
Registry dates
- Enumerated
- 2013-08-12
- Last updated
- 2020-12-31
- Certified
- 2020-12-31
Frequently asked questions
- What is Ivy Petra's NPI number?
- Ivy Petra's National Provider Identifier (NPI) is 1538592704, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ivy Petra's specialty?
- Ivy Petra is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Ivy Petra located?
- Ivy Petra's practice location on file with NPPES is 213 Middlebury St, Goshen, IN 46528.
- What is Ivy Petra's phone number?
- The practice phone number listed in the NPPES registry for Ivy Petra is (574) 534-3300.
- Does Ivy Petra accept Medicare?
- Ivy Petra is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ivy Petra's NPI active?
- Yes — Ivy Petra's NPI (1538592704) is active in the NPPES registry as of the last update on 2020-12-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.