Petty Tineo
Psychologist, Clinical in Montclair, New Jersey
1386225712- Practice location
- 1 Normal Ave, Montclair, NJ 07043-1626
- Phone
- 551-795-2266
- Fax
- —
- Last updated
- September 18, 2026
Petty Tineo is a Psychologist, Clinical based in Montclair, NJ. Petty Tineo practices in Montclair, NJ. The NPI Number for Petty Tineo is 1386225712 and holds a License No. 027342 (NY). The current practice location address for Petty Tineo is 1 Normal Ave, Montclair, NJ 07043-1626 and can be reached out via phone at 551-795-2266.
Provider Profile Details
- NPI Number
- 1386225712
- Provider Name
- Petty Tineo
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1 Normal Ave, Montclair, NJ 07043-1626
- Phone Number
- 551-795-2266
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- April 17, 2021
- Last Update Date
- September 18, 2026
- Certification Date
- September 18, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Normal Ave
Montclair, NJ 07043-1626 - City
- Montclair
- State
- New Jersey
- Zip
- 07043-1626
- Phone Number
- 551-795-2266
Provider Business Mailing Address Details
- Address
- 1 Normal Ave
Montclair, NJ 07043-1626 - City
- Montclair
- State
- NJ
- Zip
- 07043-1626
- Phone Number
- 551-795-2266
License Information
- License Number
- 027342
- License State
- NY
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Petty Tineo?
The NPI number of Petty Tineo is 1386225712. It was assigned on April 17, 2021 and is currently active in the NPPES registry.
What is the specialty of Petty Tineo?
Petty Tineo is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in NY under license number 027342.
Where does Petty Tineo practice?
The practice location is 1 Normal Ave, Montclair, NJ 07043-1626. The office can be reached at 551-795-2266 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1386225712 directly on the NPPES registry website.