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Ivy Petra, LCSW,LCAC
Clinical Social Worker in Goshen, Indiana
NPI 1538592704

Ivy Petra is a Clinical Social Worker based in Goshen, IN and is specialized in Clinical. Ivy Petra practices in Goshen, IN and has the professional credentials of LCSW,LCAC. The NPI Number for Ivy Petra is 1538592704 and holds a License No. 87001243A (Indiana).

The current practice location address for Ivy Petra is 213 Middlebury St, Goshen, IN and can be reached out via phone at 574-534-3300 and via fax at 574-534-5412.

Location: 213 Middlebury St, Goshen, IN, 46528-2956
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538592704
Provider Name
Ivy Petra
Credential
LCSW,LCAC
Provider Entity Type
Individual
Gender
Female
Address
213 Middlebury St, Goshen, IN, 46528-2956
Phone Number
574-534-3300
Fax Number
574-534-5412
Provider Enumeration Date
08/12/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
213 Middlebury St
City
Goshen
State
Indiana
Zip
46528
Phone Number
574-534-3300
Fax Number
574-534-5412
person
Provider Business Mailing Address Details
Address
213 Middlebury St
City
Goshen
State
Indiana
Zip
46528
Phone Number
574-534-3300
Fax Number
574-534-5412
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
34006676A (Indiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Social Worker
Speciality
Clinical
Taxonomy
1041C0700X
License No.
87001243A (Indiana)
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
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