Provider Demographics
NPI:1467738625
Name:PATTERSON, ALICIA (LMHC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1247
Mailing Address - Country:US
Mailing Address - Phone:978-407-9791
Mailing Address - Fax:978-600-0327
Practice Address - Street 1:53 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1247
Practice Address - Country:US
Practice Address - Phone:978-300-2511
Practice Address - Fax:978-600-0327
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health