Provider Demographics
NPI:1497872527
Name:PATTERSON, DOROTHY ROSE (LCSW, CASAC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ROSE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 SW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-4741
Mailing Address - Country:US
Mailing Address - Phone:816-820-0599
Mailing Address - Fax:816-220-1625
Practice Address - Street 1:1305 SW 23RD ST
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-4741
Practice Address - Country:US
Practice Address - Phone:816-820-0599
Practice Address - Fax:816-220-1625
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health