Provider Demographics
NPI:1356413488
Name:LINCOLN, J. PATRICK (LCSW, LPA, LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:J.
Middle Name:PATRICK
Last Name:LINCOLN
Suffix:
Gender:M
Credentials:LCSW, LPA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 PARK TEN BLVD
Mailing Address - Street 2:SUITE 298 WEST
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4211
Mailing Address - Country:US
Mailing Address - Phone:210-737-2039
Mailing Address - Fax:210-737-1396
Practice Address - Street 1:6800 PARK TEN BLVD
Practice Address - Street 2:SUITE 298 WEST
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4211
Practice Address - Country:US
Practice Address - Phone:210-737-2039
Practice Address - Fax:210-737-1396
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10092101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00540KOtherBCBS PROVIDER NUMBER