Provider Demographics
NPI:1649917675
Name:LEMLEY, PATRICK THOMAS (CDCA)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:THOMAS
Last Name:LEMLEY
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-1624
Mailing Address - Country:US
Mailing Address - Phone:937-203-2017
Mailing Address - Fax:937-203-2018
Practice Address - Street 1:4201 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-1624
Practice Address - Country:US
Practice Address - Phone:937-203-2017
Practice Address - Fax:937-203-2018
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.178572101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)