Organization
PETKAC PSYCHOTHERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S. PETKAC MA (OWNER)
(814) 882-3861
Entity
Organization
Contact information
Practice address
4021 W 12TH ST, ERIE, PA 16505-3354
(814) 882-3861
(814) 833-7944
Mailing address
4021 W 12TH ST, ERIE, PA 16505-3354
(814) 882-3861
(814) 833-7944
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
09/24/2013
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