Provider Demographics
NPI:1184948457
Name:PATTON, JOHN (LMSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:PATTON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 MARQUITA AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6178
Mailing Address - Country:US
Mailing Address - Phone:469-734-7500
Mailing Address - Fax:
Practice Address - Street 1:2800 N DALLAS PKWY STE 220
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5594
Practice Address - Country:US
Practice Address - Phone:972-473-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical