Provider Demographics
NPI:1780429092
Name:PETIT, LAUREN (MFT)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:PETIT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 GRAHAM RD STE B
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1344
Mailing Address - Country:US
Mailing Address - Phone:330-639-9444
Mailing Address - Fax:330-510-5900
Practice Address - Street 1:421 GRAHAM RD STE B
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1344
Practice Address - Country:US
Practice Address - Phone:330-639-9444
Practice Address - Fax:330-510-5900
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2400322106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist