Individual provider · Type 1 NPI
Jon P. Petruschke, LCSW
Clinical Social Worker · Portland, UM
Practice location
145 Newbury Street, Ste 2
Portland, UM 04101
Mailing address
21 Howard St
Portland, ME 04101-3208
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | LC8835 (ME) |
Clinical Social Worker: 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 interpers…
About NPI 1306021910
Jon P. Petruschke, LCSW's National Provider Identifier is 1306021910, issued on Jan 2, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Portland, UM. The record was last updated on Apr 26, 2017.