| Doctor Name: | MR. JOHN WILLIAM PETRAS |
| NPI Number: | 1881947653 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 6401000058 |
| Business Practice Address: | 615 E. Wisconsin Street Mount Pleasant, MI - 488582767 |
| Business Phone Number: | 9897739600 |
| Business Fax Number: | 9897723387 |
| Mailing Address: | 615 E. Wisconsin Street, MOUNT PLEASANT |
| State: | MI |
| Postal Code: | 488582767 |
| Phone Number: | 9897739600 |
| Fax Number: | 9897723387 |
| NPI Enumeration Date: | 10/18/2012 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6401000058 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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 |