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General NPI Number Information
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NPI Number | 1184811523
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Entity Type | Organization
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Legal Business Name | PATTON COUNSELING SERVICES
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 13422 CLAYTON RD STE 219
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City | SAINT LOUIS
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State | MO
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Zip | 63131-1008
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Country | US
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Telephone | 314-283-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 13422 CLAYTON ROAD STE 219
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City | TOWN & COUNTRY
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State | MO
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Zip | 63131-1008
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Country | US
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Telephone | 314-283-7700
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. JONNELL SUSANN PATTON
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Credential | MAC, LPC
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Telephone | 314-283-7700
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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 | 2000170903
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License Number State | MO
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