Petty, Jacquelyn
Petty, Jacquelyn is an individual health care provider with primary practice located at 130 Carbonton Rd , Sanford NC 27330-4009. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Petty, Jacquelyn can be contacted via phone (919) 774-6521.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 4807 | North Carolina |
Profile Details
| NPI number | 1053466870 |
|---|---|
| LBN Legal business name | Petty, Jacquelyn |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2007 |
| Last updated | Aug 1st, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053466870 | NPPES |
| North Carolina | MEDICAID | 6103319 |
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