Healthcare Provider Details

I. General information

NPI: 1811803562
Provider Name (Legal Business Name): BIRDS THAT SOAR COUNSELING & DEVELOPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 PEARSON ST
MATTESON IL
60443-3110
US

IV. Provider business mailing address

20015 N LAGRANGE RD # 1016
FRANKFORT IL
60423-3104
US

V. Phone/Fax

Practice location:
  • Phone: 708-941-1052
  • Fax:
Mailing address:
  • Phone: 708-941-1052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICE PATTON-CAMPBELL
Title or Position: OWNER
Credential: LCPC, NCC, CCTP
Phone: 708-941-1052