Provider Demographics
NPI:1801458815
Name:PETITT, AUNNA (LMHC)
Entity type:Individual
Prefix:
First Name:AUNNA
Middle Name:
Last Name:PETITT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:AUNNA
Other - Middle Name:
Other - Last Name:STRUTZENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3104 LEAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2152
Mailing Address - Country:US
Mailing Address - Phone:402-332-6129
Mailing Address - Fax:
Practice Address - Street 1:500 WILLOW AVE STE 204
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0827
Practice Address - Country:US
Practice Address - Phone:402-332-6129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA096519101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor