Provider Demographics
NPI:1568475416
Name:METZ, PATRICK (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:METZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-6718
Mailing Address - Country:US
Mailing Address - Phone:520-586-0800
Mailing Address - Fax:520-586-0116
Practice Address - Street 1:1615 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-2103
Practice Address - Country:US
Practice Address - Phone:928-428-4550
Practice Address - Fax:928-428-4588
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10399101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional