Provider Demographics
NPI:1194849521
Name:PATTERSON, MARY (LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MEZGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1157 3RD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-6000
Mailing Address - Country:US
Mailing Address - Phone:360-425-9741
Mailing Address - Fax:360-577-8879
Practice Address - Street 1:1157 3RD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-6000
Practice Address - Country:US
Practice Address - Phone:360-425-9741
Practice Address - Fax:360-577-8879
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health