Individual
JOEL D PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 BROADWAY ST, BARABOO, WI 53913-2183
(608) 355-4210
Mailing address
329 2ND AVE, BARABOO, WI 53913-2459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025011
PHYSICIANS PLUS
WI
01
—
11991
DEAN HEALTH PLAN
WI
01
—
39600574011
UNITY HEALTH INSURANCE
WI
05
—
39784200
—
WI
Enumeration date
02/14/2007
Last updated
09/11/2025
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