Mrs Tina Yvonne Pettiford, LPC - Counselor in East Saint Louis, IL

Mrs Tina Yvonne Pettiford, LPC is a Counselor - Professional based in East Saint Louis, Illinois. Mrs Tina Yvonne Pettiford is licensed to practice in Illinois (license number 178.006219) and her current practice location is 5501 N Park Dr, East Saint Louis, Illinois. She can be reached at her office (for appointments etc.) via phone at (618) 244-5119.

NPI number for Mrs Tina Yvonne Pettiford is 1366711939 and her current mailing address is 3805 Robin Dr, Mount Vernon, Illinois. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366711939.

Contact Information

Mrs Tina Yvonne Pettiford, LPC
5501 N Park Dr,
East Saint Louis, IL 62204-2121
(618) 244-5119
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMrs Tina Yvonne Pettiford
GenderFemale
SpecialityCounselor - Professional
Location5501 N Park Dr, East Saint Louis, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1366711939
  • Provider Enumeration Date: 12/27/2011
  • Last Update Date: 12/27/2011

Medical Identifiers

Medical identifiers for Mrs Tina Yvonne Pettiford such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366711939NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor 178.006219 (Illinois)Secondary
101YM0800XCounselor - Mental Health 178.006219 (Illinois)Secondary
101YP2500XCounselor - Professional 178.006219 (Illinois)Primary
101YS0200XCounselor - School 2341716 (Illinois)Secondary
106H00000XMarriage & Family Therapist 178.006219 (Illinois)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Tina Yvonne Pettiford is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Tina Yvonne Pettiford, LPC
3805 Robin Dr,
Mount Vernon, IL 62864-2268

Ph: (618) 244-5119
Mrs Tina Yvonne Pettiford, LPC
5501 N Park Dr,
East Saint Louis, IL 62204-2121

Ph: (618) 244-5119

Reviews and Comments


Counselor in East Saint Louis, IL

Marianna Peterson, MSW
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Phone: 618-213-3170    Fax: 618-493-6390
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Mayra Velasco,
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Practice Location: 5601 State St, East Saint Louis, IL 62203
Phone: 618-213-3170    Fax: 618-213-3171
Timothy J Kelly, MA, LCPC
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Medicare: Not Enrolled in Medicare
Practice Location: 601 James R Thompson Blvd, Building D, Suite 2015, East Saint Louis, IL 62201
Phone: 618-482-6959    

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