Provider Demographics
NPI:1659817047
Name:METTLE, PATRICK (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:METTLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 S HIGH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5644
Mailing Address - Country:US
Mailing Address - Phone:614-625-7183
Mailing Address - Fax:614-221-8912
Practice Address - Street 1:580 S HIGH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5644
Practice Address - Country:US
Practice Address - Phone:614-625-7183
Practice Address - Fax:614-221-8912
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1500786101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional