Stacie N Petitgout, is a
Psychologist based in Cuba, Illinois. Stacie N Petitgout is licensed to practice in * (Not Available) (license number ) and her current practice location is
652 E Main St, Cuba, Illinois. She can be reached at her office (for appointments etc.) via phone at
(309) 785-8054.
NPI number for Stacie N Petitgout is 1598280133 and her current mailing address is 652 E Main St, Cuba, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598280133.
Healthcare Provider's Profile
Full Name | Stacie N Petitgout |
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Gender | Female |
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Speciality | Psychologist |
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Location | 652 E Main St, Cuba, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1598280133
- Provider Enumeration Date: 08/04/2017
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for Stacie N Petitgout such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598280133 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacie N Petitgout is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Stacie N Petitgout, 652 E Main St, Cuba, IL 61427-5211 Ph: (309) 785-8054 | Stacie N Petitgout, 652 E Main St, Cuba, IL 61427-5211 Ph: (309) 785-8054 |
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