Provider Demographics
NPI:1770744393
Name:FAIRHURST, PATRICIA HUGHES
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:HUGHES
Last Name:FAIRHURST
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:HUGHES
Other - Last Name:FAIRHURST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:35 FREESTONE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-4908
Mailing Address - Country:US
Mailing Address - Phone:281-419-8768
Mailing Address - Fax:
Practice Address - Street 1:9201 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3621
Practice Address - Country:US
Practice Address - Phone:281-466-8602
Practice Address - Fax:281-466-8605
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
10807171M00000X
16051225C00000X
TX03350101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor