Provider Demographics
NPI:1457672651
Name:BAUGH, PATRIA (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRIA
Middle Name:
Last Name:BAUGH
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 SILAS DEANE HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4332
Mailing Address - Country:US
Mailing Address - Phone:860-837-0401
Mailing Address - Fax:
Practice Address - Street 1:1177 SILAS DEANE HWY STE 3
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4332
Practice Address - Country:US
Practice Address - Phone:608-370-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional