Provider Demographics
NPI:1497031264
Name:PETTE, NARCISA ELENA (PMHNP-BC, LMHC)
Entity Type:Individual
Prefix:
First Name:NARCISA
Middle Name:ELENA
Last Name:PETTE
Suffix:
Gender:F
Credentials:PMHNP-BC, LMHC
Other - Prefix:
Other - First Name:NARCISA
Other - Middle Name:ELENA
Other - Last Name:CRACIUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:68 MOPUS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-1236
Mailing Address - Country:US
Mailing Address - Phone:516-770-4314
Mailing Address - Fax:
Practice Address - Street 1:42 DANBURY RD FL 2
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4019
Practice Address - Country:US
Practice Address - Phone:516-770-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005602101YM0800X
NYF405072363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty