Individual provider · Type 1 NPI

Mary Louise Petrisko, LCSW

Clinical Social Worker · Evansville, IN

NPI number 1922102201 Active

Practice location

6221 Physicians Ct, Suite 2
Evansville, IN 47715-4031

Fax (812) 491-8095

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X34003567A (IN)

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…

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About NPI 1922102201

Mary Louise Petrisko, LCSW's National Provider Identifier is 1922102201, issued on Sep 8, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Evansville, IN. The record was last updated on Feb 8, 2012.