Provider Information for 1952986952
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
NATHAN SAMUEL PETTIT MS, LMHC, MCAP
Sex: Male
NPI: 1952986952
Last Updated: 2023-09-23
Certification Date: 2023-09-23
Certification Date: 2023-09-23
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1952986952 | ||||||||||||
| Enumeration Date | 2021-03-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2442 LAURENTINA LN CAPE CORAL, FL 33909-5280 United States Phone: 239-240-2121 | Fax: | ||||||||||||
| Primary Practice Address | 2442 LAURENTINA LN CAPE CORAL, FL 33909-5280 United States Phone: 239-240-2121 | Fax: | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|