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General NPI Number Information
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NPI Number | 1407076672
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Entity Type | Individual
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Provider Name | MICHAEL JOHN PATTERSON LMSW
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Gender | Male
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 114 N MAIN ST STE 11
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City | CHELSEA
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State | MI
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Zip | 48118-1514
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Country | US
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Telephone | 734-231-0659
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Fax |
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Provider Business Mailing Address
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Address Line | 6520 CLEAR LAKE ROAD
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City | GRASS LAKE
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State | MI
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Zip | 49240
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Country | US
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Telephone | 734-231-0659
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6802065499
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License Number State | MI
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