Provider Demographics
NPI:1356604912
Name:PATTON, JEREMY ALEXANDER (LPC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:ALEXANDER
Last Name:PATTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 JEROMY LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5679
Mailing Address - Country:US
Mailing Address - Phone:828-606-7724
Mailing Address - Fax:828-298-4870
Practice Address - Street 1:116 JEROMY LN
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-5679
Practice Address - Country:US
Practice Address - Phone:828-606-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health