Petersen, Beth M
Petersen, Beth M is an individual health care provider with primary practice located at 421 Chestnut St , Evansville IN 47713-1227. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Petersen, Beth M can be contacted via phone (812) 426-9779.Contact Information
Primary practice address
421 Chestnut St
Evansville IN 47713-1227
Phone: (812) 426-9779
Fax: (812) 426-6610
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20042022A | Indiana |
Profile Details
| NPI number | 1518941384 |
|---|---|
| LBN Legal business name | Petersen, Beth M |
| Credentials | PSY. D. HSPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Jan 9th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518941384 | NPPES |
| Indiana | MEDICAID | 200806070 | |
| Indiana | Other | 371620 |
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