Provider Demographics
NPI:1669717179
Name:PATTERSON, SCOTT J (MA, LPCC, LADAC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:J
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:MA, LPCC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 EMBUDO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-3631
Mailing Address - Country:US
Mailing Address - Phone:505-385-5086
Mailing Address - Fax:
Practice Address - Street 1:1919 EMBUDO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-3631
Practice Address - Country:US
Practice Address - Phone:505-385-5086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0129241101YA0400X
NM0155001101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health