Provider Demographics
NPI:1881733954
Name:POPE, PATRICIA A (LMFT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:POPE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W 2ND SOUTH ST
Mailing Address - Street 2:P.O. BOX 618
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-1618
Mailing Address - Country:US
Mailing Address - Phone:217-854-4511
Mailing Address - Fax:217-854-8049
Practice Address - Street 1:525 W 2ND SOUTH ST
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-1618
Practice Address - Country:US
Practice Address - Phone:217-854-4511
Practice Address - Fax:217-854-8049
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist