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General NPI Number Information
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NPI Number | 1316556913
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Entity Type | Individual
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Provider Name | MITCHELL PATTERSON
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Gender | Male
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 20 E BROAD ST STE 209
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City | COLUMBUS
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State | OH
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Zip | 43215-5880
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Country | US
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Telephone | 380-444-6548
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Fax |
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Provider Business Mailing Address
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Address Line | 5589 MEDINAH DR APT B
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City | HILLIARD
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State | OH
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Zip | 43026-5301
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Country | US
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Telephone | 216-849-1447
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2308951
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 0001916
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License Number State | OH
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