Kelly Ann Pettit is a Clinical in Mchenry, Illinois. Kelly Ann Pettit practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kelly Ann Pettit is 1194999409. The last update date is 2023-05-29.
Kelly Ann Pettit's current location address is 659 Ridgeview Dr, Mchenry, Illinois. You can contact this provider via phone number 8153441999. The mailing address for Kelly Ann Pettit is 659 Ridgeview Dr, Mchenry, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Ann Pettit |
|---|---|
| Address | 659 Ridgeview Dr, Mchenry, Illinois |
| Phone Number | 8153441999 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1194999409 |
|---|---|
| Provider Enumeration Date | 2008-04-17 |
| Last Updated Date | 2023-05-29 |
Provider Mailing Address Detail
| Address | 659 Ridgeview Dr |
|---|---|
| City | Mchenry |
| State | Illinois (IL) |
| Post Code | 600507012 |
| Phone Number | 8153441999 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71007917 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 71007917 | IL | STATE LICENSE |
Post Comment/ Review Below
What is the unique identifier code issued to Kelly Ann Pettit by the Centers for Medicare & Medicaid Services (CMS)?
The Kelly Ann Pettit has been assigned the NPI (National Provider Identifier) 1194999409. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Kelly Ann Pettit is located?
The Kelly Ann Pettit is situated at the following address: 659 Ridgeview Dr, Mchenry, IL, 600507012.
What is Kelly Ann Pettit's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Kelly Ann Pettit is Clinical, and the taxonomy code that categorizes this field of expertise is 103Tc0700X.
When was the Kelly Ann Pettit's 1194999409 issued?
The Kelly Ann Pettit's 1194999409 was issued on 2008-04-17.
As of what date was the information pertaining to Kelly Ann Pettit, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Kelly Ann Pettit, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2023-05-29.