Provider Demographics
NPI:1639651557
Name:PATTERSON BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:PATTERSON BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:508-373-6591
Mailing Address - Street 1:4237 ATLANTA DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-1509
Mailing Address - Country:US
Mailing Address - Phone:508-373-6591
Mailing Address - Fax:508-859-7082
Practice Address - Street 1:4237 ATLANTA DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-1509
Practice Address - Country:US
Practice Address - Phone:508-373-6591
Practice Address - Fax:508-859-7082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty