Mike Petagna, LPC | |
824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 | |
(623) 907-1457 | |
Not Available |
Full Name | Mike Petagna |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 824 N 99th Ave Ste 107-108, Avondale, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1831784115 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 19678 (Arizona) | Primary |
Entity Name | Community Bridges Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558095315 PECOS PAC ID: 2062699721 Enrollment ID: O20110606000388 |
Mailing Address | Practice Location Address |
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Mike Petagna, LPC 1855 W Baseline Rd Ste 101, Mesa, AZ 85202-9098 Ph: (480) 831-7566 | Mike Petagna, LPC 824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 Ph: (623) 907-1457 |
Ms. Margaret Frances Bauman, LISAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10320 W Mcdowell Rd, Ste. G-7024, Avondale, AZ 85392 Phone: 602-258-6797 Fax: 623-936-4085 | |
Dominiqiue Janay Jenkins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10320 W Mcdowell Rd Ste 7022, Avondale, AZ 85392 Phone: 623-215-8189 | |
Danielle Spies, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10320 W Mcdowell Rd Ste 7022, Avondale, AZ 85392 Phone: 623-215-8189 | |
Deja Armstrong, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10320 W Mcdowell Rd Ste 7022, Avondale, AZ 85392 Phone: 480-674-7618 | |
Christiana Hines, Counselor Medicare: Medicare Enrolled Practice Location: 950 E Van Buren St, Avondale, AZ 85323 Phone: 623-687-1199 | |
Erin Hammit, LPC Counselor Medicare: Medicare Enrolled Practice Location: 235 W Western Ave, Avondale, AZ 85323 Phone: 602-230-7373 Fax: 602-230-3086 | |
Genesis Orozco, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10320 W Mcdowell Rd Ste 7022, Avondale, AZ 85392 Phone: 623-215-8189 |