Ivy Petra LCSW, LCAC

  • NPI 1538592704
According to our database, the NPI number for Ivy Petra LCSW, LCAC is 1538592704 and activated since 10 years ago. Ivy Petra LCSW, LCAC is an individual provider who specializes in Addiction (Substance Use Disorder), and the primary practice location is 213 Middlebury St, Goshen, IN 46528. You can also contact Ivy Petra LCSW, LCAC via telephone number is (574) 534-3300. Provider NPI information was last updated on 12/31/2020.

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Overview of Ivy Petra LCSW, LCAC

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Female
  • Active since: 08/12/2013
  • Last updated: 12/31/2020

Primary Scrop of Practice

  • Taxonomy Code: 101YA0400X
  • Specialty: Addiction (Substance Use Disorder)
  • License Number: 87001243A
  • License State: IN

Provider Mailing Address

  • Address: 213 Middlebury St
    Goshen, IN 46528
  • Phone: 574-534-3300
  • Fax: 574-534-5412

Provider Practice Location

  • Address: 213 Middlebury St
    Goshen, IN 46528
  • Phone: 574-534-3300
  • Fax: 574-534-5412

Scope of Practice

  • Taxonomy Code: 101YA0400X
  • Specialty: Addiction (Substance Use Disorder)
  • License Number: 87001243A
  • License State: IN
  • Switch: No

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Ivy Petra LCSW, LCAC?
  • A: The npi number for Ivy Petra LCSW, LCAC is 1538592704.
  • Q: What are Ivy Petra LCSW, LCAC's specialties?
  • A: Ivy Petra LCSW, LCAC's specialties are Addiction (Substance Use Disorder) and different specialities.
  • Q: What is the medical license for Ivy Petra LCSW, LCAC?
  • A: The medical license number for Ivy Petra LCSW, LCAC is 87001243A and issued in IN in USA.
  • Q: Where is Ivy Petra LCSW, LCAC practice location?
  • A: Ivy Petra LCSW, LCAC is practicing at 213 Middlebury St, Goshen, IN 46528.
  • Q: How to contact Ivy Petra LCSW, LCAC?
  • A: You can contact Ivy Petra LCSW, LCAC via 574-534-3300.