Individual
RONALD PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
655 E JERSEY ST, BEHAVIORAL HEALTH, ELIZABETH, NJ 07206-1259
(908) 994-5000
Mailing address
655 E JERSEY ST, BEHAVIORAL HEALTH, ELIZABETH, NJ 07206-1259
(908) 994-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
37LC00068100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00068100
NJ STATE LICENSE
NJ
Enumeration date
08/31/2007
Last updated
08/31/2007
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