Provider Demographics
NPI:1598311631
Name:PATRICK, BARBARA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:PATRICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 N 10TH AVE APT D
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-6300
Mailing Address - Country:US
Mailing Address - Phone:724-422-9486
Mailing Address - Fax:
Practice Address - Street 1:2900 PLANK RD STE 9
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9361
Practice Address - Country:US
Practice Address - Phone:814-944-4722
Practice Address - Fax:814-266-2880
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional