Provider Demographics
NPI:1831577881
Name:PATTEN, KATELYN NICOLE (MS, LPC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:NICOLE
Last Name:PATTEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:NICOLE
Other - Last Name:RADSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:575 LESTER AVE
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8694
Mailing Address - Country:US
Mailing Address - Phone:608-783-1452
Mailing Address - Fax:608-783-1456
Practice Address - Street 1:575 LESTER AVE
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650
Practice Address - Country:US
Practice Address - Phone:608-783-1452
Practice Address - Fax:608-783-1456
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100045005Medicaid
WI6536-125OtherLICENSED PROFESSIONAL COUNSELOR