Provider Demographics
NPI:1366504037
Name:PETRANTO, ANGELA MARIE (MA, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIE
Last Name:PETRANTO
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ATRIUM DR
Mailing Address - Street 2:
Mailing Address - City:YARDVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9641
Mailing Address - Country:US
Mailing Address - Phone:609-291-8237
Mailing Address - Fax:609-291-8237
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BLDG. 4 SUITE 1C
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-291-8237
Practice Address - Fax:609-291-8237
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC#00015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health