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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. TINA YVONNE PETTIFORD, LPC

Active

Professional Counselor · EAST SAINT LOUIS, IL

Registration Details

NPI Number
1366711939
Provider Type
Individual
Gender
Female
NPI Issued
Dec 27, 2011 (14.351564412328 yrs)
Last Updated
Dec 27, 2011
Licenses
178.006219 (IL)
178.006219 (IL)
178.006219 (IL)
2341716 (IL)
178.006219 (IL)

Practice Information

Address
5501 N PARK DR
EAST SAINT LOUIS, IL, 622042121
Browse IL providers · Browse ZIP 62204
Phone
6182445119
Primary Specialty
Professional Counselor
101YP2500X
Additional Specialty
Mental Health Counselor
Additional Specialty
Professional Counselor
Additional Specialty
School Counselor
Additional Specialty
Marriage & Family Therapist

Other Professional Counselor Providers in EAST SAINT LOUIS, IL

Name Credential NPI
MS. MARGI LYNN WAGNER-FARLEY 1659563096
MS. ALICIA MICHELLE COLLIER 1851866610
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.