Provider Demographics
NPI:1831130186
Name:PATTERSON, DAVID J (PHD, LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7846 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7639
Mailing Address - Country:US
Mailing Address - Phone:918-808-0468
Mailing Address - Fax:
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE #400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-388-6241
Practice Address - Fax:918-388-6456
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional