Provider Demographics
NPI:1013112960
Name:WELCH, PATRICK PAUL (PASTORAL COUNSELOR)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:PAUL
Last Name:WELCH
Suffix:
Gender:M
Credentials:PASTORAL COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 STYERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023
Mailing Address - Country:US
Mailing Address - Phone:336-712-0057
Mailing Address - Fax:
Practice Address - Street 1:5041 STYERS FERRY RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023
Practice Address - Country:US
Practice Address - Phone:336-712-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional