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General NPI Number Information
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NPI Number | 1093729451
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Entity Type | Individual
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Provider Name | PATRICIA A VANDERPOOL MS, LPC, CEAP, SAP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 25369 US HIGHWAY 98 STE F
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City | DAPHNE
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State | AL
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Zip | 36526-4864
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Country | US
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Telephone | 251-753-8906
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 182
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City | DAPHNE
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State | AL
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Zip | 36526-0182
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Country | US
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Telephone | 251-753-8906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH21404
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1067
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1067
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License Number State | AL
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