Provider Demographics
NPI:1790057214
Name:PATTERSON, RONI LILLIAN (LMHC)
Entity Type:Individual
Prefix:
First Name:RONI
Middle Name:LILLIAN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S 2ND ST
Mailing Address - Street 2:#1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-5206
Mailing Address - Country:US
Mailing Address - Phone:646-593-0013
Mailing Address - Fax:
Practice Address - Street 1:105 S 2ND ST
Practice Address - Street 2:#1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-5206
Practice Address - Country:US
Practice Address - Phone:646-593-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004766-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health