Provider Demographics
NPI:1497811103
Name:FOGAL, PATRICIA O (LPC, CAC, NCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:O
Last Name:FOGAL
Suffix:
Gender:F
Credentials:LPC, CAC, NCC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:O
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CAC, NCC
Mailing Address - Street 1:1100 POWELL ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3820
Mailing Address - Country:US
Mailing Address - Phone:610-277-4600
Mailing Address - Fax:610-275-0216
Practice Address - Street 1:1100 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3820
Practice Address - Country:US
Practice Address - Phone:610-277-4600
Practice Address - Fax:610-275-0216
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPC000152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional