Provider Demographics
NPI:1578999579
Name:PATTON, CARLA STUMPF (EDD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:STUMPF
Last Name:PATTON
Suffix:
Gender:F
Credentials:EDD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9080 58TH DR E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6111
Mailing Address - Country:US
Mailing Address - Phone:941-726-2038
Mailing Address - Fax:
Practice Address - Street 1:9080 58TH DR E
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6111
Practice Address - Country:US
Practice Address - Phone:941-726-2038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health