Provider Demographics
NPI:1497498141
Name:PATTERSON, SHELLEY MARIE (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:MARIE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 KINGSBURY RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-9261
Mailing Address - Country:US
Mailing Address - Phone:309-264-3233
Mailing Address - Fax:
Practice Address - Street 1:1003 N CUMMINGS LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-9646
Practice Address - Country:US
Practice Address - Phone:309-444-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.107306104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker