Mary Louise Petrisko in Evansville - Clinical
Mary Louise Petrisko - NPI 1922102201
Mary Louise Petrisko is a Clinical in Evansville, Indiana. Mary Louise Petrisko practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Louise Petrisko is 1922102201. The last update date is 2012-02-08.
Mary Louise Petrisko's current location address is 6221 Physicians Ct, Evansville, Indiana. You can contact this provider via phone number 8124917739 and fax number 8124918095. The mailing address for Mary Louise Petrisko is 6221 Physicians Ct, Evansville, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Louise Petrisko |
|---|---|
| Address | 6221 Physicians Ct, Evansville, Indiana |
| Phone Number | 8124917739 |
| Fax Number | 8124918095 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1922102201 |
|---|---|
| Provider Enumeration Date | 2006-09-08 |
| Last Updated Date | 2012-02-08 |
Provider Mailing Address Detail
| Address | 6221 Physicians Ct |
|---|---|
| City | Evansville |
| State | Indiana (IN) |
| Post Code | 477154031 |
| Phone Number | 8124917739 |
| Fax Number | 8124918095 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 34003567A |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 301641 | IN | ANTHEM BCBS |
Post Comment/ Review Below
What is the Mary Louise Petrisko's unique identification number?
The Mary Louise Petrisko has been assigned the NPI (National Provider Identifier) Number 1922102201 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Mary Louise Petrisko is geographically located?
The Mary Louise Petrisko is physically situated at the following location: 6221 Physicians Ct, Evansville, IN, 477154031.
What is Mary Louise Petrisko's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Louise Petrisko's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date was the 1922102201 assigned to Mary Louise Petrisko?
The Mary Louise Petrisko was issued its 1922102201 on 2006-09-08, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Mary Louise Petrisko last refreshed?
The information related to the Mary Louise Petrisko, including its address, specialty, and other relevant details, was last updated on 2012-02-08.