Provider Demographics
NPI:1033825773
Name:KIM PATTON LCSW LLC
Entity Type:Organization
Organization Name:KIM PATTON LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MBR LCSW
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-305-3117
Mailing Address - Street 1:7050 W PALMETTO PARK ROAD
Mailing Address - Street 2:STE 15-412
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433
Mailing Address - Country:US
Mailing Address - Phone:561-305-3117
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:7050 W PALMETTO PARK ROAD
Practice Address - Street 2:STE 15-412
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433
Practice Address - Country:US
Practice Address - Phone:561-305-3117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty