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NPI Code Detail

MEDICARE: KRISTOPHER PATTERSON

MEDICARE: KRISTOPHER PATTERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistWV
2101YA0400XAddiction (Substance Use Disorder) CounselorWV

General Provider Information

NPI Number : 1679250534
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTOPHER PATTERSON
Provider Business Mailing Address
First Line : 706 OAKMOUND RD
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-9398
Country : US
Telephone Number : 394-622-7511
Fax Number : 304-622-6856
Provider Business Practice Location Address
First Line : 706 OAKMOUND RD
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-9398
Country : US
Telephone Number : 304-622-7511
Fax Number : 304-622-6856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2023
Last Update Date : 05/20/2026

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