Provider Demographics
NPI:1710155932
Name:PATTON, SAMUEL (LPC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:PATTON
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 1:130 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1821
Mailing Address - Country:US
Mailing Address - Phone:307-235-3333
Mailing Address - Fax:
Practice Address - Street 1:130 N ASH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1821
Practice Address - Country:US
Practice Address - Phone:307-235-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health