Provider Demographics
NPI:1184811523
Name:PATTON COUNSELING SERVICES
Entity type:Organization
Organization Name:PATTON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONNELL
Authorized Official - Middle Name:SUSANN
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LPC
Authorized Official - Phone:314-283-7700
Mailing Address - Street 1:13422 CLAYTON ROAD
Mailing Address - Street 2:STE 219
Mailing Address - City:TOWN & COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1008
Mailing Address - Country:US
Mailing Address - Phone:314-283-7700
Mailing Address - Fax:
Practice Address - Street 1:13422 CLAYTON RD
Practice Address - Street 2:STE 219
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1008
Practice Address - Country:US
Practice Address - Phone:314-283-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000170903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty