MEDICARE: MS. CATHY PETCHEL MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	103TF0000X	Family Psychologist
3	103T00000X	Psychologist
4	103TC2200X	Clinical Child & Adolescent Psychologist
5	103TC1900X	Counseling Psychologist
6	103TB0200X	Cognitive & Behavioral Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	516593	OTHER	PA	BLUE SHIELD PROVIDER #

General Provider Information

NPI Number	:	1184728578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHY PETCHEL MA

Provider Business Mailing Address
First Line	:	1580 MCLAUGHLIN RUN RD STE 260
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	724-941-0700
Fax Number	:	724-941-2907

Provider Business Practice Location Address
First Line	:	1580 MCLAUGHLIN RUN RD STE 260
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-3100
Country	:	US
Telephone Number	:	724-941-0700
Fax Number	:	724-941-2907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	01/23/2026

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