Healthcare Provider Details

I. General information

NPI: 1447827126
Provider Name (Legal Business Name): DR. ANTOINETTE PIGATT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/23/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 SUSHRUTA DR STE C
MARTINSBURG WV
25401-8801
US

IV. Provider business mailing address

PO BOX 1371
MARTINSBURG WV
25402-1371
US

V. Phone/Fax

Practice location:
  • Phone: 681-446-7071
  • Fax: 681-446-7079
Mailing address:
  • Phone: 304-616-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC13414
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2782
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberAP2330008
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC13414
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2782
License Number StateWV
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2782
License Number StateWV
# 7
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC13414
License Number StateMD
# 8
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2782
License Number StateWV
# 9
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC13414
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: