Provider Demographics
NPI:1023691359
Name:TOWNSEND-ZALES, PATRICIA R (LPC, LCADC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:R
Last Name:TOWNSEND-ZALES
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9034 AZALEA SANDS LN
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8111
Mailing Address - Country:US
Mailing Address - Phone:973-464-9240
Mailing Address - Fax:
Practice Address - Street 1:9034 AZALEA SANDS LN
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-8111
Practice Address - Country:US
Practice Address - Phone:973-464-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00250500101YA0400X
NJ37PC00662000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00000OtherNONE