Provider Demographics
NPI:1003980046
Name:PATE, JOLIE (LMHC)
Entity Type:Individual
Prefix:
First Name:JOLIE
Middle Name:
Last Name:PATE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BOWDOIN ST
Mailing Address - Street 2:1A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4245
Mailing Address - Country:US
Mailing Address - Phone:857-891-9479
Mailing Address - Fax:
Practice Address - Street 1:17 BOWDOIN ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4245
Practice Address - Country:US
Practice Address - Phone:857-891-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health