Healthcare Provider Details

I. General information

NPI: 1215718879
Provider Name (Legal Business Name): T'ANA PATTERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 LORD BALTIMORE DR STE 110
WINDSOR MILL MD
21244-5804
US

IV. Provider business mailing address

9301 ANNAPOLIS RD
LANHAM MD
20706-3115
US

V. Phone/Fax

Practice location:
  • Phone: 410-844-0770
  • Fax:
Mailing address:
  • Phone: 240-296-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: