Provider Demographics
NPI:1730654344
Name:CORRENTE, PATTI-JEAN
Entity Type:Individual
Prefix:
First Name:PATTI-JEAN
Middle Name:
Last Name:CORRENTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:S. CHRISTA MCAULIFFE SHOOL 570 BEACON STREET
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850
Mailing Address - Country:US
Mailing Address - Phone:978-937-2838
Mailing Address - Fax:
Practice Address - Street 1:S. CHRISTA MCAULIFFE SHOOL 570 BEACON STREET
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850
Practice Address - Country:US
Practice Address - Phone:978-937-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115568-SW-LICSW1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool