Individual
JOSEPH DANIEL PETRUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
124 AMHERST ST, WINCHESTER, VA 22601-4114
(540) 667-6272
(540) 542-0406
Mailing address
124 AMHERST ST, WINCHESTER, VA 22601-4114
(540) 667-6272
(540) 542-0406
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904000087
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087912
ANTHEM BC/BS
VA
05
—
8937931
—
VA
Enumeration date
02/07/2006
Last updated
06/18/2008
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