Gervais, Petra

Gervais, Petra is an individual health care provider with primary practice located at 20 Broad St , Westfield MA 01085-2902. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gervais, Petra can be contacted via phone (413) 572-4107.

Contact Information

Primary practice address
20 Broad St Westfield MA 01085-2902
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1063540714
LBN Legal business name Gervais, Petra
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063540714 NPPES
Massachusetts Other 0300010 MBHP
Massachusetts MEDICAID 1300881 MBHP

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