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Mrs. Tina Yvonne Pettiford, LPC
Marriage & Family Therapist in East Saint Louis, Illinois
NPI 1366711939

Tina Yvonne Pettiford is a Marriage & Family Therapist based in Mount Vernon, IL. Tina Yvonne Pettiford practices in East Saint Louis, IL and has the professional credentials of LPC. The NPI Number for Tina Yvonne Pettiford is 1366711939 and holds a License No. 178.006219 (Illinois).

The current practice location address for Tina Yvonne Pettiford is 5501 N Park Dr, East Saint Louis, IL and can be reached out via phone at 618-244-5119.

Location: 5501 N Park Dr, East Saint Louis, IL, 62864-2268
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366711939
Provider Name
Tina Yvonne Pettiford
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
5501 N Park Dr, East Saint Louis, IL, 62864-2268
Phone Number
618-244-5119
Fax Number
Provider Enumeration Date
12/27/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5501 N Park Dr
City
East Saint Louis
State
Illinois
Zip
62204-2121
Phone Number
618-244-5119
Fax Number
person
Provider Business Mailing Address Details
Address
5501 N Park Dr
City
East Saint Louis
State
Illinois
Zip
62204-2121
Phone Number
618-244-5119
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
178.006219 (Illinois)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
2341716 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
178.006219 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
School
Taxonomy
101YS0200X
License No.
178.006219 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
178.006219 (Illinois)
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
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