Provider Demographics
NPI:1114149077
Name:PETROPOULOS, PATRICIA A (MA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:PETROPOULOS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1117
Mailing Address - Country:US
Mailing Address - Phone:978-392-2297
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1815
Practice Address - Country:US
Practice Address - Phone:978-685-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)