Healthcare Provider Details

I. General information

NPI: 1215377288
Provider Name (Legal Business Name): KRISTIN MARIE PATCHELL MS, NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2013
Last Update Date: 07/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N WASHINGTON AVE SUITE 711
SCRANTON PA
18503-1549
US

IV. Provider business mailing address

420 MADISON AVE
SCRANTON PA
18510-2436
US

V. Phone/Fax

Practice location:
  • Phone: 973-271-1619
  • Fax:
Mailing address:
  • Phone: 973-271-1619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006186
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: