Provider Demographics
NPI:1891940854
Name:PATTERSON, JON C (LPC)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:C
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:JON
Other - Middle Name:C
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:410 FORREST RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-2708
Mailing Address - Country:US
Mailing Address - Phone:404-234-6117
Mailing Address - Fax:404-604-3705
Practice Address - Street 1:345 BOULEVARD NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1216
Practice Address - Country:US
Practice Address - Phone:404-234-6117
Practice Address - Fax:404-604-3705
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 005240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health