Provider Demographics
NPI:1780859405
Name:PINKSTON, PATRICIA H (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:H
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17360 CARIBOU DR E
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8552
Mailing Address - Country:US
Mailing Address - Phone:719-278-3625
Mailing Address - Fax:
Practice Address - Street 1:17360 CARIBOU DR E
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8552
Practice Address - Country:US
Practice Address - Phone:719-278-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional