Provider Demographics
NPI:1467610881
Name:CLEVELAND, PATRICK WILLIAM (LPC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:LPC
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 1769
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:NM
Mailing Address - Zip Code:88231-1769
Mailing Address - Country:US
Mailing Address - Phone:517-444-0476
Mailing Address - Fax:
Practice Address - Street 1:1738 WYNKOOP ST STE 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1000
Practice Address - Country:US
Practice Address - Phone:517-444-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007845101YP2500X
CO469106H00000X
CO1797101YP2500X
HI95106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist