Provider Demographics
NPI:1346431442
Name:PATTERSON, TYLER D (LMSW)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:D
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2019
Mailing Address - Country:US
Mailing Address - Phone:515-532-2811
Mailing Address - Fax:319-343-1161
Practice Address - Street 1:5901 THORNTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2422
Practice Address - Country:US
Practice Address - Phone:515-327-2000
Practice Address - Fax:515-327-2019
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0069661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical