Provider Demographics
NPI:1013068451
Name:DOANE, PATRICIA GILLEN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:GILLEN
Last Name:DOANE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9807 VEIRS DR APT 301
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3890
Mailing Address - Country:US
Mailing Address - Phone:240-464-8294
Mailing Address - Fax:301-983-1953
Practice Address - Street 1:9807 VEIRS DR APT 301
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3890
Practice Address - Country:US
Practice Address - Phone:240-464-8294
Practice Address - Fax:301-983-1953
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0097101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF127-0003OtherBLUECROSSBLUESHIELD
MD354333OtherMHN
MD633623OtherNCPPO
MDPVPB220350OtherAPS
MDLVT260915801OtherBCBS
MD52-1336890OtherUBH
MD252910-000OtherMAGELLAN
MD2134491OtherMAMSI
MD354333OtherTRI CARE
MD409997400Medicaid
MD52-1336890OtherPCHS
MD5546090OtherAETNA