Provider Demographics
NPI:1447827126
Name:PIGATT, ANTOINETTE
Entity type:Individual
Prefix:DR
First Name:ANTOINETTE
Middle Name:
Last Name:PIGATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1371
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25402-1371
Mailing Address - Country:US
Mailing Address - Phone:304-616-9698
Mailing Address - Fax:
Practice Address - Street 1:1004 SUSHRUTA DR STE C
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8801
Practice Address - Country:US
Practice Address - Phone:681-446-7071
Practice Address - Fax:681-446-7079
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC13414101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 101YP2500X
WV2782101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 101YP2500X, 101YM0800X
MDAP2330008101YP1600X, 101YP1600X
MD101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional