Provider Demographics
NPI:1972046639
Name:PATTERSON, CHRISTINE (LMFT, LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMFT, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W BERGERA RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:BRAIDWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60408-1518
Mailing Address - Country:US
Mailing Address - Phone:815-405-8704
Mailing Address - Fax:
Practice Address - Street 1:330 W BERGERA RD UNIT D
Practice Address - Street 2:
Practice Address - City:BRAIDWOOD
Practice Address - State:IL
Practice Address - Zip Code:60408-1518
Practice Address - Country:US
Practice Address - Phone:815-405-8704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL31106101YA0400X
IL180.010803101YP2500X
IL166001100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional