Provider Demographics
NPI:1659572444
Name:FATATO & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FATATO & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:FATATO
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCP
Authorized Official - Phone:269-962-4414
Mailing Address - Street 1:335 CARPENTER DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-9712
Mailing Address - Country:US
Mailing Address - Phone:269-962-4414
Mailing Address - Fax:269-962-5070
Practice Address - Street 1:335 CARPENTER DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-9712
Practice Address - Country:US
Practice Address - Phone:269-962-4414
Practice Address - Fax:269-962-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007576101YP2500X
MI68010874441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty