Erica Lynn Petry, MA | |
2501 Hanley Rd Ste 201, Hudson, WI 54016-8786 | |
(534) 544-5247 | |
(534) 544-5248 |
Full Name | Erica Lynn Petry |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 2501 Hanley Rd Ste 201, Hudson, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336519255 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 16016-131 (Wisconsin) | Secondary |
101YP2500X | Counselor - Professional | 6017-125 (Wisconsin) | Primary |
Entity Name | Nystrom & Associates Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592 |
Mailing Address | Practice Location Address |
---|---|
Erica Lynn Petry, MA 2501 Hanley Rd Ste 201, Hudson, WI 54016-8786 Ph: (534) 544-5247 | Erica Lynn Petry, MA 2501 Hanley Rd Ste 201, Hudson, WI 54016-8786 Ph: (534) 544-5247 |
Rochelle K Anderson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St Ste 100, Hudson, WI 54016 Phone: 715-381-5437 Fax: 715-381-5438 | |
Ms. Joan N Fuller, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 4th St, Suite 160, Hudson, WI 54016 Phone: 763-210-9966 Fax: 763-210-6886 | |
Renee L. Vannocker, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St, Ste 100, Hudson, WI 54016 Phone: 715-381-5437 Fax: 715-381-5438 | |
Daniel Patrick Jordan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 Crest View Dr Ste 120, Hudson, WI 54016 Phone: 651-292-2434 | |
Amelia L Evans, M.S., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St, Suite 104, Hudson, WI 54016 Phone: 715-377-0000 Fax: 715-377-0010 | |
William Oelke, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St Ste 103, Hudson, WI 54016 Phone: 715-808-8555 Fax: 715-808-8533 | |
Stephanie Jo Nolan, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2501 Hanley Rd Ste 201, Hudson, WI 54016 Phone: 534-544-5247 Fax: 534-544-5248 |