Healthcare Provider Details

I. General information

NPI: 1013574409
Provider Name (Legal Business Name): PATRICIA MICHELLE CARRINGTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16535 W BLUEMOUND RD STE 200
BROOKFIELD WI
53005-5906
US

IV. Provider business mailing address

10105 W COLDSPRING RD APT 106
GREENFIELD WI
53228-2632
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax: 262-821-6180
Mailing address:
  • Phone: 414-559-0845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7366-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: