MRS. TINA YVONNE PETTIFORD LPC
NPI 1366711939
Counselor - Professional in East Saint Louis, IL

Q: What is Tina Pettiford's NPI number?

The NPI number for Tina Pettiford is 1366711939. It was assigned to this individual provider in the NPPES registry on December 27, 2011. The provider is also known as Tina Yvonne Mitchell Lpc.

Q: What is Tina Pettiford's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Tina Pettiford was last updated on December 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 27, 2011

5501 N PARK DR, EAST SAINT LOUIS, IL 62204(618) 244-5119 Get Directions Write a Review

NPPES record last updated: December 27, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Tina Yvonne Pettiford Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. TINA YVONNE PETTIFORD LPC (NPI 1366711939) is an individual professional provider in East Saint Louis, Illinois, licensed in Illinois (178.006219) and active in the NPI registry since December 2011.

NPPES Registry Identity

NPI1366711939

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMRS. TINA YVONNE PETTIFORDCredential: LPC

Location Address5501 N PARK DREast Saint Louis, IL 62204-2121

Mailing Address3805 Robin DrMount Vernon, IL 62864-2268 · (618) 244-5119

Phone(618) 244-5119

Sole ProprietorNo

Enumeration DateDecember 27, 2011

✔ NPI 1366711939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 178.006219

Also ListedCounselorTaxonomy 101Y00000X · License 178.006219 (IL)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 178.006219 (IL)

Also ListedCounselor · SchoolTaxonomy 101YS0200X · License 2341716 (IL)

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 178.006219 (IL)

5501 N PARK DR, East Saint Louis, IL 62204

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Other Names 1

Former Name (1)Tina Yvonne Mitchell Lpc

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOUSE OF PRAYER CHRISTIAN ACADEMY

Counselor

5501 N PARK DR
EAST SAINT LOUIS, IL 62204

St. Clair County (618) 274-3850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tina Pettiford's NPI number?

The NPI number for Tina Pettiford is 1366711939. It was assigned to this individual provider in the NPPES registry on December 27, 2011. The provider is also known as Tina Yvonne Mitchell Lpc.

Where is Tina Pettiford located?

Tina Pettiford practices at 5501 N Park Dr, East Saint Louis, IL 62204. The listed phone number is (618) 244-5119.

What is Tina Pettiford's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Tina Pettiford was last updated on December 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.