Provider Demographics
NPI:1609168053
Name:PATTERSON, JAMES VICTOR (MA, MDIV, LMFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VICTOR
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MA, MDIV, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N LAST CHANCE GULCH
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5012
Mailing Address - Country:US
Mailing Address - Phone:406-686-6463
Mailing Address - Fax:307-426-4133
Practice Address - Street 1:516 E 18TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4618
Practice Address - Country:US
Practice Address - Phone:307-509-0772
Practice Address - Fax:307-426-4133
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLMFT-168106H00000X
MTSWP-LMFT-LIC-4524106H00000X
MTSWP-LCPC-LIC-4541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional