Organization
BOBBI PETRANCHUK
Active
Other names
US Army Medical Department
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBI PETRANCHUK LCSW-R (SOCIAL WORKER)
(315) 772-2151
Entity
Organization
Contact information
Practice address
11050 MT BELVEDERE BLVD RM 1113, FORT DRUM, NY 13602-2603
(315) 772-2151
Mailing address
11050 MT BELVEDERE BLVD RM 1113, FORT DRUM, NY 13602-2603
(315) 772-2151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00354316
—
NY
Enumeration date
04/07/2022
Last updated
09/23/2024
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