Provider Demographics
NPI:1265290613
Name:PETRAS, BRIDGETTE LAUREN (MS, CAADC, LPC)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:LAUREN
Last Name:PETRAS
Suffix:
Gender:F
Credentials:MS, CAADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3397
Mailing Address - Country:US
Mailing Address - Phone:724-249-2749
Mailing Address - Fax:
Practice Address - Street 1:400 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3397
Practice Address - Country:US
Practice Address - Phone:724-249-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health