Healthcare Provider Details

I. General information

NPI: 1235666082
Provider Name (Legal Business Name): KENDALL D PATTERSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 202-483-8196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC9110
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: