Provider Demographics
NPI:1629460365
Name:BATEK, PETRA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PETRA
Middle Name:
Last Name:BATEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10408 RUNVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2086
Mailing Address - Country:US
Mailing Address - Phone:317-353-7568
Mailing Address - Fax:
Practice Address - Street 1:10408 RUNVIEW CIR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2086
Practice Address - Country:US
Practice Address - Phone:317-353-7568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006610A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical