Provider Demographics
NPI:1639334022
Name:PATE, DAVID C (MS, LPC, LCAS, CCS)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:C
Last Name:PATE
Suffix:
Gender:M
Credentials:MS, LPC, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 BATTLEGROUND AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2617
Mailing Address - Country:US
Mailing Address - Phone:336-355-7872
Mailing Address - Fax:
Practice Address - Street 1:3225 BATTLEGROUND AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2617
Practice Address - Country:US
Practice Address - Phone:336-355-7872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7035101YP2500X
NC1341101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104040Medicaid