Provider Demographics
NPI:1376109199
Name:PETTIGREW, TINA MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MICHELLE
Last Name:PETTIGREW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 CENTRE AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3751
Mailing Address - Country:US
Mailing Address - Phone:412-822-6190
Mailing Address - Fax:
Practice Address - Street 1:1903 COLUMBIA AVE UNIT 1F
Practice Address - Street 2:
Practice Address - City:SWISSVALE
Practice Address - State:PA
Practice Address - Zip Code:15218-1901
Practice Address - Country:US
Practice Address - Phone:412-822-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC017782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health