Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JON P PETRUSCHKE, LCSW
ActiveJON P PETRUSCHKE, LCSW is a Clinical Social Worker healthcare provider located in PORTLAND, MAINE. NPI 1306021910 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · PORTLAND, MAINE
Registration Details
- NPI Number
- 1306021910
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 2, 2008 (18.632164503215 yrs)
- Last Updated
- Apr 26, 2017
- License
-
LC8835 (ME)
Practice Information
- Address
-
145 NEWBURY STREETSTE 2PORTLAND, MAINE, 04101Browse MAINE providers · Browse ZIP 04101
- Phone
- 2077749667
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.