Provider Demographics
NPI:1184728578
Name:PETCHEL, CATHY (MA)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:PETCHEL
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 1:161 WATERDAM RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MCMURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2571
Mailing Address - Country:US
Mailing Address - Phone:724-941-0700
Mailing Address - Fax:724-941-2907
Practice Address - Street 1:161 WATERDAM RD
Practice Address - Street 2:SUITE 260
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2571
Practice Address - Country:US
Practice Address - Phone:724-941-0700
Practice Address - Fax:724-941-2907
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA516593OtherBLUE SHIELD PROVIDER #