Provider Demographics
NPI:1518605666
Name:PATTON-CAMPBELL, PATRICE DARSHALL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:DARSHALL
Last Name:PATTON-CAMPBELL
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 W 153RD ST STE 5
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5397
Mailing Address - Country:US
Mailing Address - Phone:815-503-4000
Mailing Address - Fax:
Practice Address - Street 1:7021 W 153RD ST STE 5
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5397
Practice Address - Country:US
Practice Address - Phone:815-503-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.018522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional