Provider Demographics
NPI:1811530140
Name:PATTON, ELLEN A (MA, PLPC)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:A
Last Name:PATTON
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 AIRPORT LOOP
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-8639
Mailing Address - Country:US
Mailing Address - Phone:630-267-7026
Mailing Address - Fax:
Practice Address - Street 1:421 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3522
Practice Address - Country:US
Practice Address - Phone:318-377-1072
Practice Address - Fax:318-377-9283
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LAPLPC8071101Y00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator