Provider Demographics
NPI:1710477278
Name:TOWNE-PATTON, JILAINE (LPC)
Entity Type:Individual
Prefix:
First Name:JILAINE
Middle Name:
Last Name:TOWNE-PATTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1336
Mailing Address - Country:US
Mailing Address - Phone:231-547-1144
Mailing Address - Fax:231-547-4970
Practice Address - Street 1:208 W LINCOLN ST
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-1336
Practice Address - Country:US
Practice Address - Phone:231-547-1144
Practice Address - Fax:231-547-4970
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOA50093OtherBLUE CROSS BLUE SHIELD
MI20151209439760Medicaid
MI383SYS0617-COtherHUMANA BEHAVIORAL HEALTH