MATTHEW SCOTT PETTINGA MA LPC NPI 1124533757

NPI Information

Matthew Scott Pettinga, MA, LPC is a counselor in Grand Rapids, MI. The provider is 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. Matthew Scott Pettinga, MA, LPC NPI is 1124533757. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5557 28TH ST SE STE B
GRAND RAPIDS, MI
ZIP 49512-035
Phone: (616) 303-4599

The enumeration date for this NPI number is 12/5/2017 and was last updated on 9/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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