Healthcare Provider Details

I. General information

NPI: 1477652527
Provider Name (Legal Business Name): HEATHER E. PETRENKO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER FINCH

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CLARK AVE
UNION MO
63084-1004
US

IV. Provider business mailing address

1800 COMMUNITY
CLINTON MO
64735-8804
US

V. Phone/Fax

Practice location:
  • Phone: 844-853-8937
  • Fax:
Mailing address:
  • Phone: 660-885-8131
  • Fax: 660-885-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2026021854
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: