Provider Demographics
NPI:1639617277
Name:SCRUGGS, PATRICIA (LAPC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SCRUGGS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6875 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:#312
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5741
Mailing Address - Country:US
Mailing Address - Phone:404-787-6146
Mailing Address - Fax:
Practice Address - Street 1:4536 BARCLAY DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7145
Practice Address - Country:US
Practice Address - Phone:770-458-8711
Practice Address - Fax:770-458-8640
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health