Provider Demographics
NPI:1013769215
Name:MCDADE, PATRICK BURKE
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:BURKE
Last Name:MCDADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 BRIGADOON DR APT 21
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3071
Mailing Address - Country:US
Mailing Address - Phone:919-417-3615
Mailing Address - Fax:
Practice Address - Street 1:3708 LYCKAN PKWY STE 205
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2586
Practice Address - Country:US
Practice Address - Phone:919-514-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health