Provider Demographics
NPI:1609210517
Name:PETAK, MEGAN (M ED)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:PETAK
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MORGANTOWN ST STE 7000
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4878
Mailing Address - Country:US
Mailing Address - Phone:724-557-6598
Mailing Address - Fax:724-550-4160
Practice Address - Street 1:315 MORGANTOWN ST STE 7000
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4878
Practice Address - Country:US
Practice Address - Phone:724-557-6598
Practice Address - Fax:724-550-4160
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health