Provider Demographics
NPI:1376081604
Name:PETRI, BRIDGET (MS, LPCC-S)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:PETRI
Suffix:
Gender:F
Credentials:MS, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 GREENMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2853
Mailing Address - Country:US
Mailing Address - Phone:937-479-0502
Mailing Address - Fax:
Practice Address - Street 1:529 E STROOP RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3245
Practice Address - Country:US
Practice Address - Phone:937-210-9754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2001609101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health