Provider Demographics
NPI:1275879504
Name:PATTON, MARIA F (LBSW,CCM)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:F
Last Name:PATTON
Suffix:
Gender:F
Credentials:LBSW,CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6239
Mailing Address - Country:US
Mailing Address - Phone:803-926-0724
Mailing Address - Fax:803-926-0724
Practice Address - Street 1:1120 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-6239
Practice Address - Country:US
Practice Address - Phone:803-926-0724
Practice Address - Fax:803-926-0724
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3733171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator