Provider Demographics
NPI:1871685537
Name:MCFADYEN, PATRICIA R (MA,LPC,NCC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:R
Last Name:MCFADYEN
Suffix:
Gender:F
Credentials:MA,LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 ARENDELL ST
Mailing Address - Street 2:PO BOX 1305
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4278
Mailing Address - Country:US
Mailing Address - Phone:252-725-1355
Mailing Address - Fax:
Practice Address - Street 1:2301 SHORE DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-9415
Practice Address - Country:US
Practice Address - Phone:252-725-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC428517OtherTRICARE
NC56538OtherBCBS NC
NC6103119Medicaid