Provider Demographics
NPI:1225571342
Name:NAGEL, PATRICK (LPC #C4530)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:NAGEL
Suffix:
Gender:M
Credentials:LPC #C4530
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 943
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-5211
Mailing Address - Country:US
Mailing Address - Phone:503-683-7144
Mailing Address - Fax:
Practice Address - Street 1:1832 8TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-5211
Practice Address - Country:US
Practice Address - Phone:503-683-7144
Practice Address - Fax:971-275-1931
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR3676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health