Provider Demographics
NPI:1073246260
Name:CARDER, PATRICIA A (LMHCA, LSWAIC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:CARDER
Suffix:
Gender:F
Credentials:LMHCA, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10306 NE BURTON RD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-7632
Mailing Address - Country:US
Mailing Address - Phone:360-910-3475
Mailing Address - Fax:
Practice Address - Street 1:754 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3845
Practice Address - Country:US
Practice Address - Phone:360-910-3475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61183741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health