Provider Demographics
NPI:1245588573
Name:DENNIS, PATRICIA KATHLEEN (LPC-A, LCAS-P)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:KATHLEEN
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LPC-A, LCAS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 EDGEWARE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1864
Mailing Address - Country:US
Mailing Address - Phone:910-286-9593
Mailing Address - Fax:910-213-2156
Practice Address - Street 1:1995 US 421 N
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-7436
Practice Address - Country:US
Practice Address - Phone:910-814-4243
Practice Address - Fax:910-814-4245
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X
NCA8411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)