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General NPI Number Information
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NPI Number | 1114945516
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Entity Type | Individual
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Provider Name | MICHAEL EUGENE PATTERSON LPC
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 6220 BLUE RIDGE CUTOFF STE 302
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City | RAYTOWN
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State | MO
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Zip | 64133-3730
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Country | US
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Telephone | 816-806-3399
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Fax | --
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Provider Business Mailing Address
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Address Line | 14407 LAQUINTA DR
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City | GRANDVIEW
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State | MO
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Zip | 64030-4107
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Country | US
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Telephone | 816-806-3399
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2003031779
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License Number State | MO
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