Provider Demographics
NPI:1760464614
Name:PATTERSON, ALTON M (LPCC, LADAC)
Entity Type:Individual
Prefix:
First Name:ALTON
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:LPCC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15134
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-5134
Mailing Address - Country:US
Mailing Address - Phone:505-526-6616
Mailing Address - Fax:505-526-7163
Practice Address - Street 1:1750 E LOHMAN AVE
Practice Address - Street 2:STE. B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-0702
Practice Address - Country:US
Practice Address - Phone:505-526-6616
Practice Address - Fax:505-526-7163
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3535101YA0400X
NM0996101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMA9503Medicaid