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NICKOLAS PETRAGALLO CRM/PSS
NPI 1740887561
Peer Specialist in Bend, OR

Active since October 05, 2020
908 NE 4TH ST STE 101, BEND, OR 97701(541) 617-7365 Get Directions Write a Review

NPPES record last updated: October 5, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nickolas Petragallo Crm/pss NPPES

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

NICKOLAS PETRAGALLO CRM/PSS (NPI 1740887561) is an individual peer specialist in Bend, Oregon, licensed in Oregon (20-CRM-242) and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1740887561
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameNICKOLAS PETRAGALLOCredential: CRM/PSS
Location Address908 NE 4TH ST STE 101Bend, OR 97701-4646
Mailing Address908 Ne 4th St Ste 101Bend, OR 97701-4646 · (541) 617-7365
Phone(541) 617-7365
Sole ProprietorNo
Enumeration DateOctober 5, 2020
NPPES CertifiedOctober 5, 2020
✔ NPI 1740887561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in OR · 20-CRM-242
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
908 NE 4TH ST STE 101, Bend, OR 97701
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Other Providers at the Same Location NPPES 10

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

VALERIE BRODBECK QMHP
Counselor (Mental Health)
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365
MR. ANTHONY BARBER CRM
Peer Specialist
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 233-6699
JOHN LONG CADC
Counselor (Addiction (Substance Use Disorder))
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365
MR. BRENNAN MYERLE WASHBURN CADC-R, CRM, PSS
Peer Specialist
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 280-4139
RENEE DAWN TENDERELLA
Counselor (Addiction (Substance Use Disorder))
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365
SARAH WIGGERS CADC
Counselor (Addiction (Substance Use Disorder))
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365
DOREEN FULK CADC-R, QMHP-R
Counselor
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365
LEA CISERO BLUMBERG QMHP
Counselor (Mental Health)
908 NE 4TH ST STE 101
BEND, OR 97701
Deschutes County (541) 617-7365

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 Nickolas Petragallo's NPI number?

The NPI number for Nickolas Petragallo is 1740887561. It was assigned to this individual provider in the NPPES registry on October 5, 2020.

Where is Nickolas Petragallo located?

Nickolas Petragallo practices at 908 NE 4th St Ste 101, Bend, OR 97701. The listed phone number is (541) 617-7365.

What is Nickolas Petragallo's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Nickolas Petragallo was last updated on October 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.