Carolyn Marie Petterson, AAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

10447 Issued in PA

Practice address

411 W Pine St
Mahanoy City, PA 17948-2515

Phone

(570) 875-7622

Fax

(570) 773-1103

NPI assigned

Dec 3, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eric E. Petterson P.C.

  • Addiction Medicine (Internal Medicine) Physician
  • Mahanoy City, PA
  • NPI 1245787530
  NPD
• Eric E. Petterson P.C.

  • Addiction Medicine (Internal Medicine) Physician
  • Shenandoah, PA
  • NPI 1518417690
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1699280479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W PINE ST",
            "city": "MAHANOY CITY",
            "state": "PA",
            "postal_code": "179482515",
            "telephone_number": "570-875-7622",
            "fax_number": "570-462-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W PINE ST",
            "city": "MAHANOY CITY",
            "state": "PA",
            "postal_code": "179482515",
            "telephone_number": "570-875-7622",
            "fax_number": "570-773-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-03",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "10447",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "10447",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mahanoy City Emergency Medical Inc
• Beverly Ann Martin
• Milefsky Chiropractic PC
• Daniel W Milefsky Jr., D.C.
• Lorraine A Montoni, RPH
• Eric Evan Petterson, MD
• Professional Counseling Consulting & Human Services LLC
• Professional Counseling Consulting & Human Services LLC
• Rite Aid of Pennsylvania LLC
• Riteaid Pharmacy

• Addiction (Substance Use Disorder) Counselor in Mahanoy City, PA
• Providers in Mahanoy City, PA by specialty
• Addiction (Substance Use Disorder) Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.