| Doctor Name: | RICHARD ROSS PETTY |
| NPI Number: | 1033450119 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 075916 |
| Business Practice Address: | 248 Main Street Oneida, NY - 13421 |
| Business Phone Number: | 3153635274 |
| Business Fax Number: | 3153634925 |
| Mailing Address: | 1408 Genesee St, UTICA |
| State: | NY |
| Postal Code: | 13502 |
| Phone Number: | 3157242158 |
| Fax Number: | 3157325318 |
| NPI Enumeration Date: | 03/14/2013 |
| NPI Last Update Date: | 03/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 075916 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |